The Effect of Beta-Blocker Therapy on Two Year Mortality in Patients Discharged after Myocardial Infarction with Clinical Evidence of Congestive Heart Failure

1999 ◽  
Vol 97 (s41) ◽  
pp. 3P-3P
Author(s):  
NP Durham ◽  
RJ Sapsford ◽  
KS Spargias ◽  
MB Robinson ◽  
DC Greenwood ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Beta Blocker ◽  
Clinical Evidence ◽  
Blocker Therapy ◽  
Beta Blocker Therapy

Abstract 15224: Importance of Beta Blocker Subtype for the Risk of Perioperative Adverse Events in Patients Without Heart Failure and Myocardial Infarction

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Mads E Jørgensen ◽  
Gunnar H Gislason ◽  
Christian Torp-Pedersen ◽  
Mark Hlatky ◽  
C harlotte Andersson
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Beta Blocker ◽  
Beta Blockers ◽  
Cardiovascular Death ◽  
Adverse Outcomes ◽  
Major Adverse Cardiovascular Events ◽  
Blocker Therapy ◽  
Beta Blocker Therapy ◽  
Increased Risk

Objective: Beta blocker therapy in patients undergoing surgery is being revisited. Previous studies have demonstrated increased risks of perioperative adverse outcomes associated with beta blocker therapy, but whether some beta blocker subtypes may be superior to others remains unknown. Methods: Using nationwide Danish registries we included all non-cardiac surgeries in patients without heart failure or myocardial infarction in 2005-2011. Patients were grouped according to beta blocker use prior to surgery. Risks of 30-day MACE (major adverse cardiovascular events; non-fatal myocardial infarction, non-fatal stroke or cardiovascular death) were estimated using logistic regression models adjusted for gender, age, body mass index, pharmacotherapy, comorbidities, type of surgery and surgery risk. Results: We included 607,338 patients in the study. Patients on beta blockers (n=50,480) were older with similar gender distribution (mean age 66 years [sd=12.9], 45%male) compared with patients not on beta blockers (n=556,858) (mean age 52 years [sd=17.6], 44%male). Patients on beta blockers had more comorbidities and received more pharmacotherapy (all p<0.001). Unadjusted absolute risks of MACE were increased with all beta blocker subtypes (range 1.7% for propranolol to 4.2% for sotalol) compared with untreated patients (0.8%). Odds ratios for the risk of 30-day MACE are shown in the Figure Conclusion: Patients without chronic heart failure and prior myocardial infarction were at increased risk of 30-day perioperative MACE when treated with beta blockers, with the exception of bisoprolol. Patients treated with carvedilol seemed to be at especially high risk.

scholarly journals Why do patients with congestive heart failure tolerate the initiation of beta-blocker therapy?

Circulation ◽  
1993 ◽  
Vol 88 (4) ◽  
pp. 1610-1619 ◽  
Author(s):  
H L Haber ◽  
C L Simek ◽  
L W Gimple ◽  
J D Bergin ◽  
K Subbiah ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Beta Blocker ◽  
Blocker Therapy ◽  
Beta Blocker Therapy
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