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  • Until today, only one of Prof Poldermans' manuscripts has been retracted, so the validity of his large beta blocker DECREASE trial published in the NEJM remains uncertain (3)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 July 22, 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 July 22, 2014).

Share This




More Health & Medicine News

Tuesday, July 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

TheStreet (July 21, 2014) — New research shows Gilead Science's drug Sovaldi helps in curing hepatitis C in those who suffer from HIV. In a medical study, the combination of Gilead's Hep C drug with anti-viral drug Ribavirin cured 76% of HIV-positive patients suffering from the most common hepatitis C strain. Hepatitis C and related complications have been a top cause of death in HIV-positive patients. Typical medication used to treat the disease, including interferon proteins, tended to react badly with HIV drugs. However, Sovaldi's %1,000-a-pill price tag could limit the number of patients able to access the treatment. TheStreet's Keris Lahiff reports from New York. Video provided by TheStreet
Powered by NewsLook.com
$23.6 Billion Awarded To Widow In Smoking Lawsuit

$23.6 Billion Awarded To Widow In Smoking Lawsuit

Newsy (July 20, 2014) — Cynthia Robinson claims R.J. Reynolds Tobacco Company hid the health and addiction risks of its products, leading to the death of her husband in 1996. Video provided by Newsy
Powered by NewsLook.com
Tooth Plaque Provides Insight Into Diets Of Ancient People

Tooth Plaque Provides Insight Into Diets Of Ancient People

Newsy (July 19, 2014) — Research on plaque from ancient teeth shows that our prehistoric ancestor's had a detailed understanding of plants long before developing agriculture. Video provided by Newsy
Powered by NewsLook.com
Contaminated Water Kills 3 Babies in South African Town

Contaminated Water Kills 3 Babies in South African Town

AFP (July 18, 2014) — Contaminated water in South Africa's northwestern town of Bloemhof kills three babies and hospitalises over 500 people. The incident highlights growing fears over water safety in South Africa. Duration: 02:22 Video provided by AFP
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