Which surgical patients benefit from perioperative beta-blockers?
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Which surgical patients benefit from perioperative beta-blockers? Evidence-Based Answer: In patients undergoing cardiac or vascular surgery or patients with cardiac risk factors undergoing nonvascular surgery, perioperative beta-blockers reduce 30-day risk of acute myocardial infarction (NNT=57) and 1-year mortality (NNT=28), but do not change 30-day mortality. This benefit is partially offset by increased risk of stroke (NNH=177) (SOR: A, meta-analysis of RCTs). Patients with 2 or more Revised Cardiac Risk Index (RCRI) factors taking beta-blockers have a lower 30-day mortality than patients not taking beta-blockers undergoing vascular or nonvascular surgery (SOR: B, single cohort study).
Evidence Based Practice 18(11): 12-13