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Beta-blockers improve outcomes of bypass surgery

DURHAM, N.C. Giving patients a class of drugs known as beta-blockers prior to coronary artery bypass surgery improves the outcome of the surgery, according to a study by researchers from Duke University Medical Center, Louisiana State University Health Sciences Center and the Society of Thoracic Surgeons (STS).

Furthermore, the researchers believe that all patients scheduled to undergo bypass surgery except for those whose hearts are severely weakened should receive these drugs before surgery. Since only about 60 percent of bypass patients currently receive beta-blockers before surgery, the researchers believe that by working together, cardiologists and surgeons can improve survival rates of their heart patients.

The team's findings are published in the May 1, 2002 issue of the Journal of the American Medical Association.

By blocking the stimulatory effects of the hormones epinephrine and norepinephrine -- the "fight-or-flight" hormones -- beta-blockers reduce heart rate and blood pressure. Beta-blockers have been used for 20 years for different ailments. Cardiologists use them to help treat high blood pressure, chest pain and heartbeat irregularities.

Randomized clinical trials have proven the effectiveness of beta-blockers in improving outcomes for heart patients in general, and for patients undergoing non-cardiac surgery. However, little data exists on the effects of beta-blockers if given to patients just before surgery.

"In our large observational analysis, we found a small but important survival benefit for patients given beta-blockers before bypass surgery," said Duke cardiologist Eric Peterson, M.D., who along with co-investigator LSU heart surgeon T. Bruce Ferguson, M.D., conducted the analysis. "This effect was seen in all types of patients, and those patients who were the sickest received the greatest benefit."

Specifically, patients receiving beta-blockers had a 30-day mortality rate of 2.8 percent, compared to 3.4
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Contact: Richard Merritt
merri006@mc.duke.edu
919-684-4148
Duke University Medical Center
30-Apr-2002


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