Document Detail


Beta-blockers and statins are individually associated with reduced mortality in patients undergoing noncardiac, nonvascular surgery.
MedLine Citation:
PMID:  17172933     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients undergoing noncardiac, nonvascular surgery are at risk for perioperative mortality owing to underlying (a)symptomatic coronary artery disease. We hypothesized that beta-blocker and statin use are associated with reduced perioperative mortality. METHODS: We performed a case-control study in 75 581 patients who underwent 108 593 noncardiac, nonvascular surgery at the Erasmus Medical Center between 1991 and 2001. Cases were the 989 patients who died during hospital stay after surgery. From the remaining patients, 1879 matched controls (age, sex, calendar year and type of surgery) were selected. Information was then obtained regarding the use of beta-blockers and statins and the presence of cardiac risk factors. RESULTS: The median age of the study population was 63 years; 61% were men. beta-blockers were less often used in cases than in controls (6.2 vs. 8.2%; P=0.05), as were statins (2.4 vs. 5.5%; P<0.001). After adjustment for the propensity of beta-blocker use and cardiovascular risk factors, beta-blockers were associated with a 59% mortality reduction (odds ratio 0.41; 95% confidence interval 0.28-0.59). Statins were associated with a 60% mortality reduction (adjusted odds ratio 0.40; 95% confidence interval 0.24-0.68). A significant interaction between beta-blockers and statins was observed (P<0.001). In the presence of each other, statins and beta-blockers were not associated with reduced mortality (adjusted odds ratio 2.0 and 95% confidence interval 0.74-5.7 and adjusted odds ratio 1.3 and 95% confidence interval 0.52-3.2). It should be, however, noted that only nine cases and 29 controls used both agents simultaneously. CONCLUSION: This case-control study provides evidence that beta-blockers and statins are individually associated with a reduction of perioperative mortality in patients undergoing noncardiac, nonvascular surgery.
Authors:
Peter G Noordzij; Don Poldermans; Olaf Schouten; Frodo Schreiner; Harm H H Feringa; Martin Dunkelgrun; Miklos D Kertai; Eric Boersma
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Coronary artery disease     Volume:  18     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2006-12-18     Completed Date:  2007-02-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  67-72     Citation Subset:  IM    
Affiliation:
Departments of Anesthesiology, Erasmus Medical Center, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / pharmacology*
Aged
Case-Control Studies
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology*
Male
Middle Aged
Netherlands / epidemiology
Odds Ratio
Surgical Procedures, Operative / mortality*
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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