Perioperative beta-blocker and statin therapy

Current Opinion in Anaesthesiology
Geraldine Daumerie, Lee A Fleisher

Abstract

Perioperative beta-blockade and statin therapy have been advocated to reduce cardiac risk of noncardiac surgery. This review evaluates recent articles published on the cardioprotective effects of perioperative therapy with these medications. Initial studies evaluating beta-blocker therapy during the perioperative period suggested that beta-blockers may be beneficial in reducing cardiac deaths and myocardial infarctions. Later studies and recent meta-analyses, however, are less favorable and suggest that beta-blockers may be associated with increased incidence of bradycardia and hypotension. One randomized trial and several cohort studies have found a significant reduction in cardiovascular complications with perioperative statin therapy. Additionally, statin withdrawal is associated with increased postoperative cardiac risk. Based upon the available evidence and guidelines, patients currently taking beta-blockers should continue these agents. Patients undergoing vascular surgery who are at high cardiac risk should also take beta-blockers. The question remains regarding the best protocol to initiate perioperative beta-blockade. Statins should be continued in patients already taking these agents prior to surgery. The optimal dura...Continue Reading

References

Apr 3, 2002·Circulation·Kim A EagleUNKNOWN International Registry for Aortic Dissection (IRAD) Investigators
Aug 21, 2002·Circulation·Richard C PasternakUNKNOWN National Heart, Lung and Blood Institute
Mar 14, 2003·Journal of Cardiothoracic and Vascular Anesthesia·Giora Landesberg
Apr 28, 2004·Journal of Vascular Surgery·Anai E S DurazzoBruno Caramelli
May 6, 2004·JAMA : the Journal of the American Medical Association·Peter K LindenauerEvan M Benjamin
Sep 8, 2004·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·M D KertaiD Poldermans
Nov 9, 2004·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·J A S BrookesC C R Bishop
Dec 31, 2004·The New England Journal of Medicine·Edward O McFallsWilliam G Henderson
Jul 29, 2005·The New England Journal of Medicine·Peter K LindenauerEvan M Benjamin
Sep 24, 2005·Stroke; a Journal of Cerebral Circulation·James KennedyThomas E Feasby
Oct 1, 2005·The American Journal of Medicine·Eric BoersmaDon Poldermans
Oct 8, 2005·BMJ : British Medical Journal·Donald RedelmeierAlexander Kopp
Apr 18, 2006·Journal of Cardiothoracic and Vascular Anesthesia·Katja HindlerCharles D Collard
Nov 24, 2006·Anesthesiology·Judy R Kersten, Lee A Fleisher
Nov 24, 2006·Anesthesiology·Katja HindlerBernhard Riedel
Dec 21, 2006·Anesthesia and Analgesia·Lee A Fleisher
Mar 14, 2007·Perspectives in Vascular Surgery and Endovascular Therapy·Steven M Santilli
Apr 27, 2007·Nihon rinsho. Japanese journal of clinical medicine·Junji Kobayashi
Jul 10, 2007·American Journal of Surgery·Carolyn BergSamir S Awad
Jul 17, 2007·The American Journal of Cardiology·Olaf SchoutenDon Poldermans

❮ Previous
Next ❯

Citations

Sep 11, 2009·The Journal of Trauma·Matthew D NealUNKNOWN Inflammation and Host Response to Injury Investigators
Sep 8, 2009·Journal of Cardiovascular Pharmacology and Therapeutics·Damian Domanski, Ernst R Schwarz
Oct 14, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Miguel Sousa-UvaUlf Landmesser
Apr 11, 2009·European Journal of Anaesthesiology·Stefan G De Hert
Jun 11, 2010·Current Opinion in Cardiology

❮ Previous
Next ❯

Related Concepts

Related Feeds

Bradyarrhythmias

Bradyarrhythmias are slow heart rates. Symptoms may include syncope, dizziness, fatigure, shortness of breath, and chest pains. Find the latest research on bradyarrhythmias here.