Recent studies suggest that the use of preoperative β blockers in cardiac surgery
may not provide improved mortality rates and may even contribute to negative clinical
outcomes. We therefore assessed the role of β blockers on several outcomes after cardiac
surgery (delirium, acute kidney injury [AKI], stroke, atrial fibrillation (AF), mortality,
and hospital length of stay) in 4,076 patients who underwent elective coronary artery
bypass grafting, coronary artery bypass grafting + valve, or valve cardiac surgery
from November 1, 2009, to September 30, 2015, at Vanderbilt Medical Center. Clinical
data from 2 prospectively collected datasets at our institution were reviewed: the
Cardiac Surgery Perioperative Outcomes Database and the Society of Thoracic Surgeons
Database. Preoperative β-blocker use was defined by Society of Thoracic Surgeons guidelines
as patients receiving a β blocker within 24 hours preceding surgery. Of the included
patients, 2,648 (65.0%) were administered a β blocker within 24 hours before surgery.
Adjusting for possible confounders, preoperative β-blocker use was associated with
increased odds of AKI stage 2 (odds ratio 1.96, 95% confidence interval 1.19 to 3.24,
p <0.01). There was no evidence that β-blocker use had an independent association
with postoperative delirium, AKI stages 1 and 3, stroke, AF, mortality, or prolonged
length of stay. A secondary propensity score analysis did not show a marginal association
between β-blocker use and any outcome. In conclusion, we did not find significant
evidence that preoperative β-blocker use was associated with postoperative delirium,
AF, AKI, stroke, or mortality.
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Article Info
Publication History
Published online: July 24, 2017
Accepted:
July 7,
2017
Received:
May 1,
2017
Footnotes
See page 1296 for disclosure information.
Research reported in this publication was supported by the National Institutes of Health under award numbers T32GM108554 , K23GM102676 , and R01GM112871 , and also by Vanderbilt Institute for Clinical and Translational Research grant number UL1 TR000445 , from NCATS/NIH .
The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Clinical Trial Number: NCT02548975.
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