In the article entitled, "Impact of Prophylactic Postoperative Beta-Blockade on Post-Cardiothoracic Surgery Length of Stay and Atrial Fibrillation," Craig I. Coleman PharmD, C. Michael White PharmD, and co-researchers at Connecticut's Hartford Hospital report findings from 1660 patients collected over a 4-year period. In the largest trial of its kind to date, all patients received standard care and half also began beta-blocker treatment shortly after surgery.
In addition to reduced hospital stays and atrial fibrillation, early beta-blocker use was also associated with significant reductions in patient death, the risk of fluid in the lungs, and the need for a balloon pump to assist the heart. Those events were reduced by 59%, 55%, and 53%, respectively. There was no difference in the occurrence of post-surgical stroke or heart attack between the two groups.
In the study a variety of beta-blockers were used at an average dose equivalent to 75 mg/day of metoprolol. Higher doses did not result in additional benefits, nor were outcomes affected by whether patients had taken a beta-blocker prior to surgery. Adverse effects during the study were not mentioned.
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Contact: Stanley J. Lloyd, Pharm.D.
Annals of Pharmacotherapy