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Coronary artery bypass surgery use of beta-blockers

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery (DO NOT EDIT)[1]

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery (DO NOT EDIT)[1]

Perioperative Beta Blockers (DO NOT EDIT)[1]

Class I
“1. Beta blockers should be administered for at least 24 hours before CABG to all patients without contraindications to reduce the incidence or clinical sequelae of postoperative AF.[2][3][4][5][6][7][8][9] (Level of Evidence: B)”
“2. Beta blockers should be reinstituted as soon as possible after CABG in all patients without contraindications to reduce the incidence or clinical sequelae of AF.[2][3][4][5][6][7][8][9] (Level of Evidence: B)”
“3. Beta blockers should be prescribed to all CABG patients without contraindications at the time of hospital discharge. (Level of Evidence: C)”
Class IIa
“1. Preoperative use of beta blockers in patients without contraindications, particularly in those with an LVEF greater than 30%, can be effective in reducing the risk of in-hospital mortality.[10][11][12] (Level of Evidence: B)”
“2. Beta blockers can be effective in reducing the incidence of perioperative myocardial ischemia.[13][14][15][16] (Level of Evidence: B)”
“3. Intravenous administration of beta blockers in clinically stable patients unable to take oral medications is reasonable in the early postoperative period.[17] (Level of Evidence: B)”
Class IIb
“1. The effectiveness of preoperative beta blockers in reducing inhospital mortality rate in patients with LVEF less than 30% is uncertain.[18][4] (Level of Evidence: B)”
References

References

  1. ↑ 1.0 1.1 Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG; et al. (2011). “2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines”. Circulation. doi:10.1161/CIR.0b013e31823c074e. PMID 22064599.
  2. ↑ 2.0 2.1 Crystal E, Garfinkle MS, Connolly SS, Ginger TT, Sleik K, Yusuf SS (2004). “Interventions for preventing post-operative atrial fibrillation in patients undergoing heart surgery”. Cochrane Database of Systematic Reviews (Online) (4): CD003611. doi:10.1002/14651858.CD003611.pub2. PMID 15495059. Retrieved 2011-12-14.
  3. ↑ 3.0 3.1 Connolly SJ, Cybulsky I, Lamy A, Roberts RS, O’brien B, Carroll S, Crystal E, Thorpe KE, Gent M (2003). “Double-blind, placebo-controlled, randomized trial of prophylactic metoprolol for reduction of hospital length of stay after heart surgery: the beta-Blocker Length Of Stay (BLOS) study”. American Heart Journal. 145 (2): 226–32. doi:10.1067/mhj.2003.147. PMID 12595838. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  4. ↑ 4.0 4.1 4.2 Andrews TC, Reimold SC, Berlin JA, Antman EM (1991). “Prevention of supraventricular arrhythmias after coronary artery bypass surgery. A meta-analysis of randomized control trials”. Circulation. 84 (5 Suppl): III236–44. PMID 1682069. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  5. ↑ 5.0 5.1 Mariscalco G, Klersy C, Zanobini M, Banach M, Ferrarese S, Borsani P, Cantore C, Biglioli P, Sala A (2008). “Atrial fibrillation after isolated coronary surgery affects late survival”. Circulation. 118 (16): 1612–8. doi:10.1161/CIRCULATIONAHA.108.777789. PMID 18824644. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  6. ↑ 6.0 6.1 Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Kay GN, Le Huezey JY, Lowe JE, Olsson SB, Prystowsky EN, Tamargo JL, Wann LS, Smith SC, Priori SG, Estes NA, Ezekowitz MD, Jackman WM, January CT, Lowe JE, Page RL, Slotwiner DJ, Stevenson WG, Tracy CM, Jacobs AK, Anderson JL, Albert N, Buller CE, Creager MA, Ettinger SM, Guyton RA, Halperin JL, Hochman JS, Kushner FG, Ohman EM, Stevenson WG, Tarkington LG, Yancy CW (2011). “2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines”. Circulation. 123 (10): e269–367. doi:10.1161/CIR.0b013e318214876d. PMID 21382897. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  7. ↑ 7.0 7.1 Silverman NA, Wright R, Levitsky S (1982). “Efficacy of low-dose propranolol in preventing postoperative supraventricular tachyarrhythmias: a prospective, randomized study”. Annals of Surgery. 196 (2): 194–7. PMC 1352475. PMID 6979982. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  8. ↑ 8.0 8.1 Al-Khatib SM, Hafley G, Harrington RA, Mack MJ, Ferguson TB, Peterson ED, Califf RM, Kouchoukos NT, Alexander JH (2009). “Patterns of management of atrial fibrillation complicating coronary artery bypass grafting: Results from the PRoject of Ex-vivo Vein graft ENgineering via Transfection IV (PREVENT-IV) Trial”. American Heart Journal. 158 (5): 792–8. doi:10.1016/j.ahj.2009.09.003. PMID 19853700. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  9. ↑ 9.0 9.1 Ali IM, Sanalla AA, Clark V (1997). “Beta-blocker effects on postoperative atrial fibrillation”. European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery. 11 (6): 1154–7. PMID 9237602. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  10. ↑ Ferguson TB, Coombs LP, Peterson ED (2002). “Preoperative beta-blocker use and mortality and morbidity following CABG surgery in North America”. JAMA : the Journal of the American Medical Association. 287 (17): 2221–7. PMID 11980522. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  11. ↑ ten Broecke PW, De Hert SG, Mertens E, Adriaensen HF (2003). “Effect of preoperative beta-blockade on perioperative mortality in coronary surgery”. British Journal of Anaesthesia. 90 (1): 27–31. PMID 12488374. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  12. ↑ Weightman WM, Gibbs NM, Sheminant MR, Whitford EG, Mahon BD, Newman MA (1999). “Drug therapy before coronary artery surgery: nitrates are independent predictors of mortality and beta-adrenergic blockers predict survival”. Anesthesia and Analgesia. 88 (2): 286–91. PMID 9972742. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  13. ↑ Chung F, Houston PL, Cheng DC, Lavelle PA, McDonald N, Burns RJ, David TE (1988). “Calcium channel blockade does not offer adequate protection from perioperative myocardial ischemia”. Anesthesiology. 69 (3): 343–7. PMID 2458058. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  14. ↑ Podesser BK, Schwarzacher S, Zwoelfer W, Binder TM, Wolner E, Seitelberger R (1995). “Comparison of perioperative myocardial protection with nifedipine versus nifedipine and metoprolol in patients undergoing elective coronary artery bypass grafting”. The Journal of Thoracic and Cardiovascular Surgery. 110 (5): 1461–9. PMID 7475198. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  15. ↑ Slogoff S, Keats AS (1988). “Does chronic treatment with calcium entry blocking drugs reduce perioperative myocardial ischemia?”. Anesthesiology. 68 (5): 676–80. PMID 2897173. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  16. ↑ Wiesbauer F, Schlager O, Domanovits H, Wildner B, Maurer G, Muellner M, Blessberger H, Schillinger M (2007). “Perioperative beta-blockers for preventing surgery-related mortality and morbidity: a systematic review and meta-analysis”. Anesthesia and Analgesia. 104 (1): 27–41. doi:10.1213/01.ane.0000247805.00342.21. PMID 17179240. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  17. ↑ Halonen J, Hakala T, Auvinen T, Karjalainen J, Turpeinen A, Uusaro A, Halonen P, Hartikainen J, Hippeläinen M (2006). “Intravenous administration of metoprolol is more effective than oral administration in the prevention of atrial fibrillation after cardiac surgery”. Circulation. 114 (1 Suppl): I1–4. doi:10.1161/CIRCULATIONAHA.105.000851. PMID 16820555. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  18. ↑ Lin T, Hasaniya NW, Krider S, Razzouk A, Wang N, Chiong JR (2010). “Mortality reduction with beta-blockers in ischemic cardiomyopathy patients undergoing coronary artery bypass grafting”. Congestive Heart Failure (Greenwich, Conn.). 16 (4): 170–4. doi:10.1111/j.1751-7133.2010.00146.x. PMID 20662870. Retrieved 2011-12-14.

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