Copyright © 2001 by the European Society of Cardiology.
Bisoprolol reduces cardiac death and myocardial infarction in high-risk patients as long as 2 years after successful major vascular surgery
a Erasmus Medical Center, Rotterdam, The Netherlands
b The University of Manitoba, Winnipeg, Canada
c University Hospital Antwerp, Antwerp, Belgium
d Sint Clara Ziekenhuis, Rotterdam, The Netherlands
g Twee Steden Ziekenhuis, Tilburg, The Netherlands
e San Gerardo Hospital, Monza, Italy
f Instituto di Ricovero e Cura a Carattere Scientifico Hospital, San Giovanni Rotondo, Italy
revised November 28, 2000; accepted November 29, 2000
Abstract
Aim To assess the long-term cardioprotective effect of bisoprolol in a randomized high-risk population after successful major vascular surgery. High-risk patients were defined by the presence of one or more cardiac risk factor(s) and a dobutamine echocardiography test positive for ischaemia.
Methods 1351 patients were screened prior to surgery, 846 patients had one or more risk factor(s), and 173 of these patients also had ischaemia during dobutamine echocardiography. One hundred and twelve patients could be randomized for additional bisoprolol therapy or standard care. Eleven patients died in the peri-operative period (up to 1 month after surgery). Randomized patients continued bisoprolol or standard care after surgery. During follow-up of 101 survivors (median 22 months, range 11–30) cardiac death or myocardial infarction was noted. No patient was lost during follow-up.
Results The incidence of cardiac events during follow-up in the bisoprolol group was 12% vs 32% in the standard care group (P=0·025). Cardiac death occurred in 15 patients, nine patients in the standard care and in six in the bisoprolol group; myocardial infarction occurred in six patients, five in the standard care and one in the bisoprolol group. The odds ratio for cardiac death or myocardial infarction after surgery in high-risk patients with additional bisoprolol therapy was 0·30 (0·11–0·83).
Conclusions Bisoprolol significantly reduced long-term cardiac death and myocardial infarction in high-risk patients after successful major cardiac vascular surgery.
Key Words: Major vascular surgery, long-term follow-up, high-risk patients, beta-blockers
f1 Correspondence: Don Poldermans, MD, PhD, Thoraxcentre, Room H921‘, Erasmus University, Rotterdam, The Netherlands.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  Y. R. B. M. van Gestel, S. E. Hoeks, D. D. Sin, G. M. J. M. Welten, O. Schouten, H. J. Witteveen, C. Simsek, H. Stam, F. W. Mertens, J. J. Bax, et al. Impact of Cardioselective {beta}-Blockers on Mortality in Patients with Chronic Obstructive Pulmonary Disease and Atherosclerosis Am. J. Respir. Crit. Care Med., October 1, 2008; 178(7): 695 - 700. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. S. Beattie, D. N. Wijeysundera, K. Karkouti, S. McCluskey, and G. Tait Does Tight Heart Rate Control Improve Beta-Blocker Efficacy? An Updated Analysis of the Noncardiac Surgical Randomized Trials Anesth. Analg., April 1, 2008; 106(4): 1039 - 1048. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. H. Levy, K. A. Tanaka, and J. M. Bailey Cardiac Surgical Pharmacology Card. Surg. Adult, January 1, 2008; 3(2008): 77 - 110. [Full Text]
|
|
|
|
 |
|
 H T Ong beta blockers in hypertension and cardiovascular disease BMJ, May 5, 2007; 334(7600): 946 - 949. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Moscucci and N. Jones Coronary Revascularization Before Noncardiac Vascular Surgery: One More Step Forward in Understanding Its Role J. Am. Coll. Cardiol., May 1, 2007; 49(17): 1770 - 1771. [Full Text] [PDF]
|
|
|
|
 |
|
 H.-J. Priebe Perioperative myocardial infarction--aetiology and prevention Br. J. Anaesth., July 1, 2005; 95(1): 3 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Tovey and J. P Thompson Anaesthesia for lower limb revascularization CEACCP, June 1, 2005; 5(3): 89 - 92. [Full Text] [PDF]
|
|
|
|
|
|
B. Subramaniam, F. Pomposelli, D. Talmor, and K. W. Park Perioperative and Long-Term Morbidity and Mortality After Above-Knee and Below-Knee Amputations in Diabetics and Nondiabetics Anesth. Analg., May 1, 2005; 100(5): 1241 - 1247. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Comfere, J. Sprung, M. M. Kumar, M. Draper, D. P. Wilson, B. A. Williams, D. R. Danielson, L. Liedl, and D. O. Warner Angiotensin System Inhibitors in a General Surgical Population Anesth. Analg., March 1, 2005; 100(3): 636 - 644. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. S. Beattie, D. N. Wijeysundera, and P. T. Choi An Alternative View of Current Evidence in Support of Perioperative {beta}-Blockers Arch Intern Med, February 14, 2005; 165(3): 347 - 348. [Full Text] [PDF]
|
|
|
|
 |
|
 J. G. Brawley and G. P. Clagett Optimizing Long-Term Cardiac Management After Major Vascular Surgery: Role of {beta}-Blocker Therapy, Clinical Characteristics, and Dobutamine Stress Echocardiography to Optimize Long-Term Cardiac Management After Major Vascular Surgery Perspectives in Vascular Surgery and Endovascular Therapy, December 1, 2004; 16(4): 336 - 337. [Abstract] [PDF]
|
|
|
|
 |
|
 I. Rapchuk, S. Rabuka, and M. Tonelli Perioperative use of beta-blockers remains low: experience of a single Canadian tertiary institution: [L'usage perioperatoire des beta-bloquants n'est pas frequent : l'experience d'un seul centre tertiaire canadien] Can J Anesth, October 1, 2004; 51(8): 761 - 767. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. D. Stoneham Editorial I: 'It ain't what you do; it's the way that you do it ...': reducing haemodynamic instability during carotid surgery Br. J. Anaesth., March 1, 2004; 92(3): 321 - 323. [Full Text] [PDF]
|
|
|
|
|
|
M. D. Kertai, E. Boersma, J. J. Bax, I. R. Thomson, M. J. Cramer, L. L. M. van de Ven, M. G. Scheffer, G. Trocino, C. Vigna, H. F. Baars, et al. Optimizing Long-term Cardiac Management After Major Vascular Surgery: Role of {beta}-Blocker Therapy, Clinical Characteristics, and Dobutamine Stress Echocardiography to Optimize Long-term Cardiac Management After Major Vascular Surgery Arch Intern Med, October 13, 2003; 163(18): 2230 - 2235. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Butterworth and C. D. Furberg Improving Cardiac Outcomes After Noncardiac Surgery Anesth. Analg., September 1, 2003; 97(3): 613 - 615. [Full Text] [PDF]
|
|
|
|
|
|
R. D. Stevens, H. Burri, and M. R. Tramer Pharmacologic Myocardial Protection in Patients Undergoing Noncardiac Surgery: A Quantitative Systematic Review Anesth. Analg., September 1, 2003; 97(3): 623 - 633. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Landesberg, M. Mosseri, Y. G. Wolf, M. Bocher, A. Basevitch, E. Rudis, U. Izhar, H. Anner, C. Weissman, and Y. Berlatzky Preoperative Thallium Scanning, Selective Coronary Revascularization, and Long-Term Survival After Major Vascular Surgery Circulation, July 15, 2003; 108(2): 177 - 183. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-H. Fleron, R. B. Weiskopf, M. Bertrand, S. Mouren, D. Eyraud, G. Godet, B. Riou, E. Kieffer, and P. Coriat A Comparison of Intrathecal Opioid and Intravenous Analgesia for the Incidence of Cardiovascular, Respiratory, and Renal Complications After Abdominal Aortic Surgery Anesth. Analg., July 1, 2003; 97(1): 2 - 12. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T Dodd and T Doyle Cyclizine Emerg. Med. J., May 1, 2003; 20(3): 302 - 302. [Full Text] [PDF]
|
|
|
|
|
|
P. W. C. ten Broecke, S. G. De Hert, E. Mertens, and H. F. Adriaensen Effect of preoperative {beta}-blockade on perioperative mortality in coronary surgery Br. J. Anaesth., January 1, 2003; 90(1): 27 - 31. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Bailey, K. A. Tanaka, and J. H. Levy Cardiac Surgical Pharmacology Card. Surg. Adult, January 1, 2003; 2(2003): 85 - 118. [Full Text]
|
|
|
|
|
|
M. Licker, G. Khatchatourian, A. Schweizer, M. Bednarkiewicz, D. Tassaux, and C. Chevalley The Impact of a Cardioprotective Protocol on the Incidence of Cardiac Complications After Aortic Abdominal Surgery Anesth. Analg., December 1, 2002; 95(6): 1525 - 1533. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P.-G. Chassot, A. Delabays, and D. R. Spahn Preoperative evaluation of patients with, or at risk of, coronary artery disease undergoing non-cardiac surgery Br. J. Anaesth., November 1, 2002; 89(5): 747 - 759. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. D. Auerbach and L. Goldman {beta}-Blockers and Reduction of Cardiac Events in Noncardiac Surgery: Scientific Review JAMA, March 20, 2002; 287(11): 1435 - 1444. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Zaugg, M. C. Schaub, T. Pasch, and D. R. Spahn Modulation of {beta}-adrenergic receptor subtype activities in perioperative medicine: mechanisms and sites of action Br. J. Anaesth., January 1, 2002; 88(1): 101 - 123. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B.N.C. Prichard and J.M. Robin Beta-blockade and surgery Eur. Heart J., August 1, 2001; 22(15): 1253 - 1255. [Abstract] [PDF]
|
|