Mortality reduction with beta-blockers in ischemic cardiomyopathy patients undergoing coronary artery bypass grafting

Area of Science:

• Cardiology
• Cardiac Surgery
• Pharmacology

Background:

• Coronary artery bypass grafting (CABG) in patients with systolic heart failure (HF) is associated with high perioperative risks.
• Beta-blockers (BBs) are commonly used medications that may mitigate these risks.

Purpose of the Study:

• To evaluate the impact of perioperative beta-blocker (BB) therapy on mortality rates in patients undergoing isolated coronary artery bypass grafting (CABG).
• Specifically, to assess outcomes in patients with and without systolic heart failure (HF).

Main Methods:

• Retrospective analysis of 4903 patients who underwent isolated CABG surgery.
• Comparison of in-hospital and 30-day mortality rates between patients who received BBs and those who did not.
• Stratification of analysis based on the presence or absence of systolic heart failure.

Main Results:

• In-hospital mortality was significantly lower in systolic HF patients receiving BBs (2.03%) compared to those not receiving BBs (5.20%).
• Thirty-day mortality was also reduced in systolic HF patients on BBs (2.98%) versus those not on BBs (6.16%).
• Beta-blockade did not impact mortality in patients with preserved systolic function; cardiogenic shock predicted increased mortality in systolic HF patients, but BBs mitigated this.

Conclusions:

• Perioperative beta-blocker therapy is associated with decreased in-hospital and 30-day mortality in patients with systolic heart failure undergoing CABG.
• BB therapy should be strongly considered for patients with systolic HF undergoing CABG surgery.
• The findings suggest a beneficial role for BBs in improving outcomes for this high-risk surgical population.