Beta-blockers protect brain during bypass surgery

DURHAM, N.C. -- When given prior to or during coronary artery bypass surgery, a class of heart drugs known as beta-blockers provides significant protection to the brain and its functions, according to a new study by Duke University Medical Center researchers.

"Data is rapidly accumulating that every patient undergoing bypass surgery -- with a few exceptions -- should be given beta-blockers for bypass surgery," said Mark Newman, M.D., Duke chairman of anesthesiology and lead investigator of Duke's Perioperative Organ Protection Consortium. "Since only about 60 percent of bypass patients nationwide are given beta-blockers for surgery, there is certainly much room for improvement in this area."

The results of the Duke analysis were published today (June 13, 2002) in the Journal of Cardiothoracic and Vascular Anesthesia. The research was supported by the National Institutes of Health and the American Heart Association.

In their study, the researchers analyzed the medical records of 2,575 patients who underwent bypass surgery at Duke over a three-year period. They found that only 3.9 percent of the patients receiving beta-blockers suffered adverse neurological events, compared to 8.2 percent of those not on the drugs. The adverse neurological effects of surgery measured were stroke, coma, transient ischemic attacks (TIA), also known as "mini-strokes," and encephalopathy.

For the most severe of the events, stroke and coma, the beneficial effect of beta-blockers was even more striking -- a 1.9 percent rate of adverse effects for those taking the drugs and 4.3 percent for those who did not.

These results follow an earlier study by a different Duke team (May 2002, Journal of the American Medical Association) that showed that beta-blockers given prior to or during bypass surgery reduced the 30-day mortality rate of the procedure from 3.4 percent to 2.8 percent. More than 570,000 of the heart

Contact: Richard Merritt
Duke University Medical Center

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