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The case for beta-adrenergic blockade as prophylaxis against perioperative cardiovascular morbidity and mortality
C H Selzman1, S A Miller, M A Zimmerman
1Division of Cardiothoracic Surgery, Department of Surgery, Box C-310, University of Colorado Health Sciences Center, 4200 E Ninth Ave, Denver, CO 80262, USA.
Insights
Beta-adrenergic antagonists can help prevent cardiac ischemic events in high-risk surgical patients. This review explores their use for cardioprotective management strategies, reducing myocardial oxygen consumption.
Area of Science:
- Cardiology
- Anesthesiology
- Cardiovascular Surgery
Background:
- Perioperative morbidity and mortality often stem from cardiac complications.
- Risk factors for cardiac ischemic events are identifiable, but optimal management remains unclear.
Purpose of the Study:
- To review the physiologic and clinical basis for using beta-adrenergic antagonists.
- To explore their role in cardioprotective management for high-risk surgical patients.
Main Methods:
- Review of existing literature on beta-adrenergic antagonists.
- Analysis of their effects on myocardial oxygen consumption.
Main Results:
- Beta-adrenergic antagonists decrease myocardial oxygen consumption.
- These agents are generally well-tolerated.
Conclusions:
- Beta-adrenergic antagonists offer a potential cardioprotective strategy.
- Further investigation into optimal management strategies is warranted.
Abstract:
Perioperative morbidity and mortality are frequently cardiac in origin. Many studies have prospectively attempted to define risk factors for cardiac ischemic events. Although we can now identify high-risk patients, optimal cardioprotective management strategies remain unclear. Treatment with beta-adrenergic antagonists decreases myocardial oxygen consumption and is generally well tolerated. This article reviews the physiologic and clinical basis for using these agents as prophylaxis against cardiovascular events in high-risk surgical patients.