Featured Research

from universities, journals, and other organizations

Beta blockers and perioperative care: EHJ editorial addresses controversy

Date:
February 7, 2014
Source:
European Society of Cardiology
Summary:
Whether beta blockers in perioperative care are protective, safe or harmful continues to be a subject of debate. The new ESC Guidelines will try to clarify some of the controversial issues. In the meantime, the current position is that "the initiation of beta blockers in patients who will undergo non-cardiac surgery should not be considered routine, but should be considered carefully by each patient's treating physician on a case-by-case basis."

Since the end of 2011 when the scientific work of Professor Don Poldermans was first scrutinized there has been controversy in the medical world about the use of beta blockers in perioperative care.

The recent publication -- and retraction for proper peer reviewing and revision -- in the European Heart Journal (EHJ) of a paper by Professors Cole and Francis from Imperial College, questioning whether beta blockers in perioperative care could lead to a mortality increase brought the topic back into the public eye.

The EHJ has published an editorial today addressing these questions.

In the editorial, Professors Thomas Lόscher, Bernard Gersh, Ulf Landmesser and Frank Ruschitzka highlight, among other points, that jumping to conclusions may be particularly dangerous for both physicians and patients. In this respect, they pointed out that:

  • The meta analysis is mainly driven by the POISE trial that used very high dosages of metoprolol immediately before surgery with further uptitration, which is not recommended by the ESC Guidelines
  • Different dosing and starting time of betablockade before surgery may importantly determine outcome
  • A registry published in 2013 in JAMA supports the use of perioperative blockade, at least in non-vascular surgery
  • Until today, only one of Prof Poldermans' manuscripts has been retracted, so the validity of his large beta blocker DECREASE trial published in the NEJM remains uncertain (3)
  • A proper clinical trial is needed in order to assess whether the use of beta blockers starting at a low dose several days before surgery -- as has been recommended by the ESC Guidelines of 2009 -- might be beneficial or harmful
  • The ESC Task Force led by Professors Steen Dalby Kristensen and Juhani Knuuti, is carefully revising all existing evidence and will present a new version of the ESC Guidelines on "Pre-operative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-Cardiac Surgery" by this summer. These will try to answer two major issues: 1° Should beta blockers be continued in patients scheduled for surgery who are already on them? 2° Should beta blockers be started in patient undergoing surgery who have never received them previously?

Whether beta blockers in perioperative care are protective, safe or harmful continues to be a subject of debate. The new ESC Guidelines will try to clarify some of the controversial issues. As stated jointly by ACC/AHA/ESC (4), in the meantime, the current position is that "the initiation of beta blockers in patients who will undergo non-cardiac surgery should not be considered routine, but should be considered carefully by each patient's treating physician on a case-by-case basis."


Story Source:

The above story is based on materials provided by European Society of Cardiology. Note: Materials may be edited for content and length.


Journal Reference:

  1. Thomas F. Lόscher, Bernard Gersh, Ulf Landmesser and Franck Ruschitzka. Is the panic about beta-blockers in perioperative care justified. European Heart Journal, February 2014 DOI: 10.1093/eurheartj/ehu056

Cite This Page:

European Society of Cardiology. "Beta blockers and perioperative care: EHJ editorial addresses controversy." ScienceDaily. ScienceDaily, 7 February 2014. <www.sciencedaily.com/releases/2014/02/140207102603.htm>.
European Society of Cardiology. (2014, February 7). Beta blockers and perioperative care: EHJ editorial addresses controversy. ScienceDaily. Retrieved April 19, 2014 from www.sciencedaily.com/releases/2014/02/140207102603.htm
European Society of Cardiology. "Beta blockers and perioperative care: EHJ editorial addresses controversy." ScienceDaily. www.sciencedaily.com/releases/2014/02/140207102603.htm (accessed April 19, 2014).

Share This



More Health & Medicine News

Saturday, April 19, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

'Holy Grail' Of Weight Loss? New Find Could Be It

'Holy Grail' Of Weight Loss? New Find Could Be It

Newsy (Apr. 18, 2014) — In a potential breakthrough for future obesity treatments, scientists have used MRI scans to pinpoint brown fat in a living adult for the first time. Video provided by Newsy
Powered by NewsLook.com
Little Progress Made In Fighting Food Poisoning, CDC Says

Little Progress Made In Fighting Food Poisoning, CDC Says

Newsy (Apr. 18, 2014) — A new report shows rates of two foodborne infections increased in the U.S. in recent years, while salmonella actually dropped 9 percent. Video provided by Newsy
Powered by NewsLook.com
Scientists Create Stem Cells From Adult Skin Cells

Scientists Create Stem Cells From Adult Skin Cells

Newsy (Apr. 17, 2014) — The breakthrough could mean a cure for some serious diseases and even the possibility of human cloning, but it's all still a way off. Video provided by Newsy
Powered by NewsLook.com
Obama: 8 Million Healthcare Signups

Obama: 8 Million Healthcare Signups

AP (Apr. 17, 2014) — President Barack Obama gave a briefing Thursday announcing 8 million people have signed up under the Affordable Care Act. He blasted continued Republican efforts to repeal the law. (April 17) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins