RT Journal Article
SR Electronic
T1 Perioperative beta-blockade: might the baby go out with the bath water?
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 604
OP 607
DO 10.7861/clinmedicine.14-6-604
VO 14
IS 6
A1 Mistry, Ravin
A1 Walker, David
YR 2014
UL http://www.rcpjournals.org/content/14/6/604.abstract
AB Perioperative β-blocker therapy has been advocated to reduce cardiac mortality and morbidity in high-risk cardiac patients undergoing non-cardiac surgery. Core data that supported this intervention and informed international societal guidelines has recently been withdrawn. A subsequent meta-analysis of the remaining data reporting excess mortality has re-opened the debate about the utility of β-blocker therapy in the perioperative period. Criticism of remaining trial designs and new insights into the protective mechanisms of β-blocker therapy in critical illness raise important questions that should now be addressed by a further robust, high-quality randomised control trial.