USE OF BETA-BLOCKERS IN THE PERIOPERATIVE PERIOD: HOW STRONG ARE THE EVIDENCES?
https://doi.org/10.20996/1819-6446-2013-9-4-420-426
Abstract
Optimization of the pharmacotherapy in preoperative period is the cornerstone of the concept of risk modification of cardiovascular complications in the perioperative period. Therefore, special attention has recently been focused on the use of beta-blockers in the postoperative period. Nowadays convincing evidence base for the use of this class of drugs in the perioperative period that was the basis for the development of clinical guidelines is accumulated. Moreover, results of large randomized trials of beta-blockers are controversial. This has resulted in significant differences in the classes of recommendations and levels of evidence.
Analysis of the results of basic researches and the provisions of recommendations of the international and national professional medical societies on the use of beta-blockers in patients with cardiovascular disease to reduce the risk of cardiac complications in the perioperative period for planned extracardiac surgical procedures is presented.
About the Authors
V. V. Samoylenko
Russian National Research Medical University named after N.I. Pirogov, Moscow
Russian Federation
Russian Federation
O. P. Shevchenko
Russian National Research Medical University named after N.I. Pirogov, Moscow
Russian Federation
Russian Federation
V. I. Burtsev
I.M. Setchenov First Moscow State Medical University, Moscow
Russian Federation
Russian Federation
References
1. Weiser TG, Regenbogen SE, Thompson KD, Haynes AB, Lipsitz SR, Berry WR, Gawande AA. An esti- mation of the global volume of surgery: a modelling strategy based on available data. Lancet 2008;372:139–44.
2. Healthcare in Russia in 2011. Statistical Compendium. Moscow: Rosstat, 2011. Russian (Здравоохранение России 2011. Статистический сборник. М.: Росстат; 2011).
3. Bainbridge D., Martin J., Arango M., Cheng D. Perioperative and anaesthetic-related mortality in developed and developing countries: a systematic review and meta-analysis. Lancet 2012; 380(9847): 1075–81.
4. Poldermans D., Devereux P.J. The experts debate: perioperative beta-blockade for non-cardiac surgery– proven safe or not. CCJM 2009; 76(Supp.4):S84–S92.
5. Smulyan H, Weinberg SE, Howanitz PJ. Continuous propranolol infusion following abdominal surgery. J Am Med Assoc 1982; 247: 2539–42.
6. Pasternack PF, Grossi EA, Baumann FG, et al. Beta blockade to decrease silent myocardial ischemia during peripheral vascular surgery. Am J Surg 1989; 158: 113–6.
7. Mangano DT, Layug EL, Wallace A, Tateo I. Effect of atenolol on mortality and cardiovascular morbidity after noncardiac surgery. Multicenter Study of Perioperative Ischemia Research Group. NEngl J Med 1996; 335: 1713–20.
8. Wallace A, Layug B, Tateo I, et al. Prophylactic atenolol reduces postoperative myocardial ischemia. McSPI Research Group. Anesthesiology 1998; 88: 7–17.
9. Poldermans D, Boersma E, Bax JJ, et al. The effect of bisoprolol on perioperative mortality and myocardial infarction in highrisk patients undergoing vascular surgery. Dutch Echocardiographic Cardiac Risk Eval-uation Applying Stress Echocardiography Study Group. N Engl J Med 1999; 341: 1789–94.
10. Brady AR, Gibbs JS, Greenhalgh RM, et al. Perioperative beta-blockade (POBBLE) for patients undergoing infrarenal vascular surgery: results of a randomized double-blind controlled trial. J Vasc Surg 2005; 41: 602–9.
11. Juul AB, Wetterslev J, Gluud C, et al. Effect of perioperative beta blockade in patients with diabetes undergoing major non-cardiac surgery: randomised placebo controlled, blinded multicentre trial. Br Med J 2006; 332: 1482.
12. Yang H, Raymer K, Butler R, et al. The effects of perioperative beta-blockade: results of the Metoprolol after Vascular Surgery (MaVS) study, a randomized controlled trial. Am Heart J 2006; 152: 983–90.
13. Zaugg M, Bestmann L, Wacker J, et al. Adrenergic receptor genotype but not perioperative bisoprolol therapy may determine cardiovascular outcome in at-risk patients undergoing surgery with spinal block: the Swiss Beta Blocker in Spinal Anesthesia (BBSA) study: a double-blinded, placebo-controlled, multicenter trial with 1-year follow-up. Anesthesiology 2007; 107: 33–44.
14. Devereaux PJ, Yang H, Yusuf S, et al. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet 2008; 371: 1839–47.
15. Dunkelgrun M, Boersma E, Schouten O, et al. Bisoprolol and fluvastatin for the reduction of periop- erative cardiac mortality and myocardial infarction in intermediate-risk patients undergoing noncar- diovascular surgery: a randomized controlled trial (DECREASE-IV). Ann Surg 2009; 249: 921–6.
16. Surkova EA, Shchukin YV, Vachev AN. Effect of beta-blockers on the incidence of coronary complications in carotid endarterectomy. Kazan Medical Journal 2006; 87 (2): 90–91. Russian (Суркова Е.А., Щукин Ю.В., Вачев А.H. Влияние бета-блокаторов на частоту развития коронарных ослож- нений при выполнении каротидной эндартерэктомии. Казанский Медицинский Журнал 2006; 87(2): 90–91).
17. Barabash O.L., Repnikova R.V., Shoforus' T.V., Golofaeva O.I. Effect of beta-blockers on blood pressure, perioperative complications and hospital stay duration in patients with intermediate risk of cardiovascular complications afterroutine cholecystectomy: an open comparative randomized study. Rational Pharmacother.Card. 2010;6(5):667–672. Russian (Барабаш О.Л., Репникова Р.В., Шофорусь Т.В., Голофаева О.И. Влияние бета-блокаторов на уровень артериального давления, пе- риоперационные осложнения и длительность госпитализации у пациентов с промежуточным риском сердечно-сосудистых осложнений при плановой холецистэктомии: открытое сравнительное рандомизированное исследование. Рациональная фармакотерапия в кардиологии 2010; 6 (5): 667–72).
18. Lindenauer PK, Pekow P, Wang K, et al. Perioperative beta-blocker therapy and mortality after major noncardiac surgery. N Engl J Med 2005; 353: 349–61.
19. London M.J., Hur K., Schwartz G.G., Henderson W.G. Association of Perioperative β-Blockade With Mortality and Cardiovascular Morbidity Following Major Noncardiac Surgery. JAMA 2013;309(16):1704–13.
20. Bangalore S, Wetterslev J, Pranesh S, et al. Perioperative beta blockers in patients having noncardiac surgery: a meta-analysis. Lancet 2008; 372: 1962–76.
21. Palda VA, Detsky AS. Perioperative assessment and management of risk from coronary artery disease. Ann Intern Med 1997; 127: 313–28.
22. Eagle KA, Brundage BH, Chaitman BR, et al. Guidelines for perioperative cardiovascular evaluation for noncardiac surgery. Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Committee on Perioperative Cardiovascular Evaluation for Noncardiac Surgery. Circulation 1996; 93(6):1278–317.
23. Eagle KA, Berger PB, Calkins H, et al. ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery—executive summary. A report of the American College of Cardiolo- gy/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996
24. Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Anesth Analg 2002; 94: 1052–64.
25. Fleisher LA, Beckman JA, Brown KA, et al. ACC/AHA 2006 guideline update on perioperative cardiovascular evaluation for noncardiac surgery: focused update on perioperative beta-blocker therapy: a report of the American College of Cardiology/American Heart Association Task Force on Prac- tice Guidelines (Writing Committee to Update the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery): developed incollaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society for Vascular Medicine and Biology. Circulation 2006; 113: 2662–74.
26. Fleisher LA., Beckman JA., Brown KA., et al. ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery. A Report of the American College of Cardiology/Amer- ican Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). JACC, 2007; 50 (17): e159–241.
27. Tricoci P., Allen JM., Kramer JM., et al. Scientific Evidence Underlying the ACC/AHA Clinical Practice Guidelines. JAMA. 2009;301(8):831–841.
28. Fleisher LA, Beckman JA, Brown KA, et al. 2009 ACCF/AHA focused update on perioperative beta blockade incorporated into the ACC/ AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Cardiology Foundation/Amer- ican Heart Association Task Force on Practice Guidelines. Circulation 2009; 120: e169–276.
29. Poldermans D, Bax JJ, Boersma E, et al. Guidelines for preoperative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery. Eur Heart J 2009; 30: 2769–812.
30. II Diretriz de Avaliação Perioperatória da Sociedade Brasileira de Cardiologia. Arq Bras Cardiol 2011;96(3 supl.1): 1–68.
31. Prise en charge du coronarien qui doit etre opere en chirurgie non cardiaque. Recommendation formalisees d’experts SFAR/SFC. 2011. Available at : www.sfcardio.fr/recommandations/recomman- dations-mixtes. Date of access 13.06.2013.
32. National guidelines for prediction and prevention of cardiac events extracardiac surgery in cardiac patients. Cardiovascular Therapy and Prevention, 2011; 10 (6) suppl 3: 1–45. Russian (Национальные рекомендации по прогнозированию и профилактике кардиальных осложнений внесердечных хирургических вмешательств у кардиологических больных. Кардиоваскулярная Терапия и Профилактика 2011; 10 (6) приложение 3: 1–45).
33. Kadoi Y, Saito S. Possible indications of beta-blockers in the perioperative period other than prevention of cardiac ischemia. J Anesth 2010, 24(1):81–95.
34. Priebe H.-J. Perioperative use of beta-blockers. F1000 Medicine Reports 2009; 1:77.
35. Nagele P., Liggett S.B. Genetic variations, β-blockers, and perioperative myocardial infarction. Anestesiology 2011;115(6):1316–27.
36. Preckel B., Poels M., Wappler F., Schlack W., Buhre W. Perioperative β-rezeptoren-blockade. Fur und Wider. Anaesthesist 2010;54:643–651.
Review
For citations:
Samoylenko V.V., Shevchenko O.P., Burtsev V.I. USE OF BETA-BLOCKERS IN THE PERIOPERATIVE PERIOD: HOW STRONG ARE THE EVIDENCES? Rational Pharmacotherapy in Cardiology. 2013;9(4):420-426. (In Russ.) https://doi.org/10.20996/1819-6446-2013-9-4-420-426
Views: 951
Email this article 