keyword
MENU ▼
Read by QxMD icon Read
search

Perioperative beta-blockers in noncardiac surgery

keyword
https://www.readbyqxmd.com/read/28671407/perioperative-cardiovascular-medication-management-in-noncardiac-surgery-common-questions
#1
Michael A Mikhail, Arya B Mohabbat, Amit K Ghosh
Several medications have been used perioperatively in patients undergoing noncardiac surgery in an attempt to improve outcomes. Antiplatelet therapy for primary prevention of cardiovascular events should generally be discontinued seven to 10 days before surgery to avoid increasing the risk of bleeding, unless the risk of a major adverse cardiac event exceeds the risk of bleeding. Antiplatelet therapy for secondary prevention should be continued perioperatively, except before procedures with very high bleeding risk, such as intracranial procedures...
May 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28641862/perioperative-beta-blockers-and-statins-for-noncardiac-surgery-patients-with-coronary-stents
#2
Joshua S Richman, Laura A Graham, Aerin DeRussy, Thomas M Maddox, Kamal M F Itani, Mary T Hawn
IMPORTANCE: Recent publications report that perioperative initiation of statin therapy is associated with improved outcomes particularly among patients with increased cardiac risk. However, findings on associations with beta blocker (BB) initiation are mixed. OBJECTIVE: This study examines associations between perioperative statin and BB use in a national sample of patients with cardiac stents. DESIGN: Retrospective cohort study. SETTING: VA Medical Centers nationwide...
August 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28366317/morbidity-and-mortality-in-elective-total-hip-arthroplasty-following-surgical-care-improvement-project-guidelines
#3
Thomas B Bemenderfer, Nigel L Rozario, Charity G Moore, Madhav A Karunakar
BACKGROUND: Following evidence questioning the safety and efficacy of perioperative beta-blocker therapy in noncardiac surgery, the Surgical Care Improvement Project (SCIP) guidelines were retired in 2015. However, perioperative myocardial infarctions and cardiac complications remain leading causes of mortality following noncardiac surgery. The impact of the SCIP guidelines on reducing cardiac complications in patients undergoing elective total hip arthroplasty (THA) has not been evaluated...
March 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28073770/impact-of-beta-blocker-initiation-timing-on-mortality-risk-in-patients-with-diabetes-mellitus-undergoing-noncardiac-surgery-a-nationwide-population-based-cohort-study
#4
Ray-Jade Chen, Hsi Chu, Lung-Wen Tsai
BACKGROUND: Relevant clinical studies have been small and have not convincingly demonstrated whether the perioperative initiation of beta-blockers should be considered in patients with diabetes mellitus undergoing noncardiac surgery. METHODS AND RESULTS: In this nationwide propensity score-matched study, we included patients with diabetes mellitus undergoing noncardiac surgery between 2000 and 2011 from Taiwan's National Health Insurance Research Database. Patients were classified as beta-blocker and non-beta-blocker cohorts...
January 10, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28032851/is-perioperative-beta-blockade-effective-and-safe-in-patients-undergoing-noncardiac-surgery
#5
REVIEW
Andrés Armstrong, Gabriel Rada, Fernando Altermatt
Beta-blockade in patients undergoing noncardiac surgery has been widely recommended as a way to reduce cardiovascular adverse events during the perioperative period. However, studies have shown contradictory results. Searching in Epistemonikos database, which is maintained by screening multiple databases, we identified 22 systematic reviews comprising 131 studies addressing the question of this article, including 112 randomized trials. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach...
December 27, 2016: Medwave
https://www.readbyqxmd.com/read/27396805/pharmacological-modification-of-the-perioperative-stress-response-in-noncardiac-surgery
#6
REVIEW
Hans-Joachim Priebe
The perioperative period is associated with alterations in the neuroendocrine, metabolic, and immune systems, referred to as "stress response." The resultant increased sympathetic activity and elevated serum concentrations of catecholamines may adversely affect the cardiovascular system, resulting in cardiovascular instability (hypertension, tachycardia, and arrhythmia), morbidity (myocardial ischemia, myocardial infarction, and stroke), and mortality (cardiac death and fatal stroke), particularly in patients at an elevated cardiovascular risk and with reduced cardiovascular reserve...
June 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/26087271/new-therapy-in-cardioprotection
#7
REVIEW
Ka Ying Chow, Sophie E Liu, Michael G Irwin
PURPOSE OF REVIEW: An increasing number of patients are presenting for major surgery with cardiovascular comorbidities. Evidence of myocardial injury was found in 8% of all noncardiac surgery patients older than 45 years and was associated with adverse outcome. For this reason, there has been a lot of interest in finding and evaluating effective cardioprotective interventions. RECENT FINDINGS: Current evidence suggests that statins, volatile anesthetic agents, and propofol are cardioprotective...
August 2015: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/25801695/quantity-over-quality-how-the-rise-in-quality-measures-is-not-producing-quality-results
#8
Michele L Esposito, Harry P Selker, Deeb N Salem
Over the past decade, quality measures (QMs) have been implemented nationally in order to establish standards aimed at improving the quality of care. With the expansion of their role in the Affordable Care Act and pay-for-performance, QMs have had an increasingly significant impact on clinical practice. However, adverse patient outcomes have resulted from adherence to some previously promulgated performance measures. Several of these QMs with unintended consequences, including the initiation of perioperative beta-blockers in noncardiac surgery and intensive insulin therapy for critically ill patients, were instituted as QMs years before large randomized trials ultimately refuted their use...
August 2015: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/25645037/cardiac-risk-assessment-decreasing-postoperative-complications
#9
Joanne L Thanavaro
Preoperative cardiac assessment helps identify patients undergoing noncardiac surgery who are at risk for significant postoperative cardiac complications and those who may benefit from additional preoperative evaluation and perioperative care. Advanced practice nurses can identify surgery- and patient-related risks by conducting a thorough health history and physical examination. Multiple risk indices and evidence-based guidelines are available to inform health care providers regarding patient evaluation and strategies to reduce postoperative cardiac risk...
February 2015: AORN Journal
https://www.readbyqxmd.com/read/25620250/-chinese-expert-recommendations-for-perioperative-beta-blocker-therapy-in-patients-undergoing-noncardiac-surgery
#10
(no author information available yet)
No abstract text is available yet for this article.
November 2014: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/25508789/-preoperative-evaluation-before-non-cardiac-surgery-in-subjects-older-than-65-years
#11
Gian Francesco Mureddu, Pompilio Faggiano, Francesco Fattirolli
Non cardiac surgery is becoming increasingly common in elderly patients; they are usually affected by overt cardiac disease or show multiple risk factors, responsible for a higher incidence of perioperative fatal or nonfatal cardiac events. Of interest, acute myocardial infarction occurring in the perioperative period shows a high mortality rate in people over 65 years old. The cardiovascular risk stratification and perioperative management of subjects undergoing noncardiac surgery have been recently updated in the 2014 European Society of Cardiology Guidelines...
March 2014: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/25481937/-preoperative-evaluation-before-non-cardiac-surgery-in-subjects-older-than-65-years
#12
Gian Francesco Mureddu, Pompilio Faggiano, Francesco Fattirolli
Non cardiac surgery is becoming increasingly common in elderly patients; they are usually affected by overt cardiac disease or show multiple risk factors, responsible for a higher incidence of perioperative fatal or nonfatal cardiac events. Of interest, acute myocardial infarction occurring in the perioperative period shows a high mortality rate in people over 65 years old. The cardiovascular risk stratification and perioperative management of subjects undergoing noncardiac surgery have been recently updated in the 2014 European Society of Cardiology Guidelines...
March 2014: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/25452352/updated-guidelines-on-cardiovascular-evaluation-before-noncardiac-surgery-a-view-from-the-trenches
#13
REVIEW
Steven L Cohn
In August 2014, the American College of Cardiology and American Heart Association updated their guidelines on cardiovascular evaluation and care before noncardiac surgery and simultaneously published a systematic review of perioperative use of beta-blockers. The update reinforces many previous recommendations and provides new evidence and expert opinion that is useful to the perioperative team.
December 2014: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/25091545/perioperative-beta-blockade-in-noncardiac-surgery-a-systematic-review-for-the-2014-acc-aha-guideline-on-perioperative-cardiovascular-evaluation-and-management-of-patients-undergoing-noncardiac-surgery-a-report-of-the-american-college-of-cardiology-american
#14
REVIEW
Duminda N Wijeysundera, Dallas Duncan, Chileshe Nkonde-Price, Salim S Virani, Jeffrey B Washam, Kirsten E Fleischmann, Lee A Fleisher
OBJECTIVE: To review the literature systematically to determine whether initiation of beta blockade within 45 days prior to noncardiac surgery reduces 30-day cardiovascular morbidity and mortality rates. METHODS: PubMed (up to April 2013), Embase (up to April 2013), Cochrane Central Register of Controlled Trials (up to March 2013), and conference abstracts (January 2011 to April 2013) were searched for randomized controlled trials (RCTs) and cohort studies comparing perioperative beta blockade with inactive control during noncardiac surgery...
December 9, 2014: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/25085989/perioperative-beta-blockers-in-noncardiac-surgery-the-evidence-continues-to-evolve
#15
REVIEW
Muzammil Mushtaq, Steven L Cohn
The effectiveness and safety of giving beta-blockers to patients undergoing noncardiac surgery remain controversial. The use of these drugs in this clinical scenario increased after the publication of two positive trials in the late 1990s and was encouraged by national organizations and clinical guidelines. However, when several subsequent studies failed to show a benefit, recommendations became more limited and use decreased. This paper reviews recent evidence for and against the perioperative use of beta-blockers...
August 2014: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/25085964/perioperative-beta-blockade-in-noncardiac-surgery-a-systematic-review-for-the-2014-acc-aha-guideline-on-perioperative-cardiovascular-evaluation-and-management-of-patients-undergoing-noncardiac-surgery-a-report-of-the-american-college-of-cardiology-american
#16
REVIEW
Duminda N Wijeysundera, Dallas Duncan, Chileshe Nkonde-Price, Salim S Virani, Jeffrey B Washam, Kirsten E Fleischmann, Lee A Fleisher
OBJECTIVE: To review the literature systematically to determine whether initiation of beta blockade within 45 days prior to noncardiac surgery reduces 30-day cardiovascular morbidity and mortality rates. METHODS: PubMed (up to April 2013), Embase (up to April 2013), Cochrane Central Register of Controlled Trials (up to March 2013), and conference abstracts (January 2011 to April 2013) were searched for randomized controlled trials (RCTs) and cohort studies comparing perioperative beta blockade with inactive control during noncardiac surgery...
December 9, 2014: Circulation
https://www.readbyqxmd.com/read/24779115/meaningful-outcome-measures-in-cardiac-surgery
#17
REVIEW
Paul S Myles
The most common cardiac surgical procedures are coronary artery bypass graft surgery and aortic or mitral valve repair or replacement. Underlying conditions include coronary artery disease and heart failure, manifesting as exertional angina, dyspnea, and poor exercise tolerance. The major goals of surgery are to alleviate symptoms and improve patient survival. These, therefore, should inform the choice of primary outcome measures in clinical studies enrolling patients undergoing cardiac surgery. Studies focusing on surrogate outcome measures are relied on all too often...
March 2014: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/24373755/duration-of-preoperative-%C3%AE-blockade-and-outcomes-after-major-elective-noncardiac-surgery
#18
COMPARATIVE STUDY
Duminda N Wijeysundera, W Scott Beattie, Harindra C Wijeysundera, Lingsong Yun, Peter C Austin, Dennis T Ko
BACKGROUND: Although practice guidelines recommend that perioperative β-blockade be initiated at least several days to weeks before noncardiac surgery is performed, the minimum required period of preoperative therapy is unclear. METHODS: Population-based administrative databases were used to conduct a cohort study of 48,103 patients aged ≥ 66 years who underwent major elective noncardiac surgery in Ontario, Canada and received preoperative β-blocker therapy...
February 2014: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/23820187/selective-%C3%AE-1-antagonism-with-bisoprolol-is-associated-with-fewer-postoperative-strokes-than-atenolol-or-metoprolol-a-single-center-cohort-study-of-44-092-consecutive-patients
#19
Catherine Ashes, Saul Judelman, Duminda N Wijeysundera, Gordon Tait, C David Mazer, Gregory M T Hare, W Scott Beattie
BACKGROUND: Perioperative metoprolol increases postoperative stroke. Animal studies indicate that the mechanism may be related to attenuated β(2)-adrenoreceptor-mediated cerebral vasodilatation. The authors therefore conducted a cohort to study whether the highly β(1)-specific β-blocker (bisoprolol) was associated with a reduced risk of postoperative stroke compared with less selective β-blockers (metoprolol or atenolol). METHODS: The authors conducted a single-center study on 44,092 consecutive patients with age 50 yr or more having noncardiac, nonneurologic surgery...
October 2013: Anesthesiology
https://www.readbyqxmd.com/read/23613075/association-of-perioperative-%C3%AE-blockade-with-mortality-and-cardiovascular-morbidity-following-major-noncardiac-surgery
#20
Martin J London, Kwan Hur, Gregory G Schwartz, William G Henderson
IMPORTANCE: The effectiveness of perioperative β-blockade in patients undergoing noncardiac surgery remains controversial. OBJECTIVE: To determine the associations of early perioperative exposure to β-blockers with 30-day postoperative outcome in patients undergoing noncardiac surgery. DESIGN, SETTING, AND PATIENTS: A retrospective cohort analysis evaluating exposure to β-blockers on the day of or following major noncardiac surgery among a population-based sample of 136,745 patients who were 1:1 matched on propensity scores (37,805 matched pairs) treated at 104 VA medical centers from January 2005 through August 2010...
April 24, 2013: JAMA: the Journal of the American Medical Association
keyword
keyword
31585
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"