-Blockers and Cardiac Events inNoncardiac SurgeryLessons from DECREASE-IV
M Chadi Alraies, MD
Department of Hospital Medicine Grand RoundCleveland Clinic Foundation
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Perioperative cardiac events
ACC/AHA Guidelines for perioperative BB use.
What is already known about perioperative
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About 20 million Americans undergo surgerywith general anesthesia each year.
Cardiac events (MI or Cardiac death) result inperioperative mortality rate of 3-6%
1. July 20, 2005 Los Angeles Times
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POISE limitations for β-Blockers and Cardiac Events in Noncardiac Surgery
Beta blockers are known for their cardioprotective properties when used in noncardiac surgeries. This was one of the main principles in the perioperative medicine. However, lately this concepts being questions and this cardio protective properties have…
Beta blockers are known for their cardioprotective properties when used in noncardiac surgeries. This was one of the main principles in the perioperative medicine. However, lately this concepts being questions and this cardio protective properties have almost fallen of the AHA/ACC guidelines giving the risk of increased mortality for patient using this medication around the surgery time.
POISE trial in 2008 was a landmark in the beta blockers literature which showed that beta blockers are not always safe and the use of this dug should me customized for each patient.
Mid 2009, Poldermans et al, showed that beta blockers is an effective medication if it is used in correct way and titrated gradually over time to make the real effect take place overtime.
In this slide show you I am reviewing the old and new literature and present the 2007 ACC/AHA perioperative guidelines and the level of evidence for this drug.
This topic is an interesting and hot topic and I hope this slide show will help you make the correct decision in your daily perioperative practice.