Perioperative metoprolol reduces the frequency of atrial fibrillation after thoracotomy for lung resection

Jakobsen, Carl-Johan; Bille, S; Ahlburg, P.; L, Rybro; Hjortholm, Kirsten; Andresen, Else Bay

doi:10.1016/s1053-0770(97)90169-5

Cited by 105 publications

(49 citation statements)

References 25 publications

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“…High-bias risk trials POBBLE 3 Poldermans 32 Jakobsen 46 Jakobsen 34 Lai 35 Magnusson 37 Magnusson 50 Stone 38 Urban 39 Zaugg 3 Poldermans 32 Jakobsen 46 Lai 35 Magnusson 37 Magnusson 50 Miller 40 Stone 38 Urban 39 Zaugg High-bias risk trials Jakobsen 426 Lai 35 Liu 36 Magnusson 50 POBBLE 3 Poldermans 32 Urban 39 Zaugg 33 Jakobsen 46 Stone …”

Section: Graph Marks Arrowsmentioning

confidence: 99%

“…[3][4][5][6]22,24,28,[30][31][32][33][34][35][36][37][38][39] However, the test for interaction did not show a significant effect of age category on any of the efficacy outcomes.…”

Section: Weight (%)mentioning

confidence: 99%

“…Five trials enrolled high surgical-risk patients (emergency surgery, vascular surgery), 3,5,27,32,40 five enrolled intermediate-risk or high surgical-risk patients, 4,6,28,30,38 22 enrolled intermediate surgical-risk patients (intrathoracic, intraperitoneal, carotid endarterectomy, head and neck, orthopedic, or prostate surgery), [22][23][24][25][26]31,[33][34][35][36][37]39,[41][42][43][44][45][46][47][48][49][50] and one enrolled low surgical-risk patients. 29 A sensitivity analysis on the basis of surgical risk categories showed a 63% decreased risk of all-cause mortality and a 44% decreased risk of non-fatal myocardial infarction in trials with high surgical risk (tables 2 and 3); this finding was driven largely by the trial by Poldermans and colleagues.…”

Section: Weight (%)mentioning

confidence: 99%

“…32 However, in the intermediate-high surgical risk trials, there was a 30% reduction in the risk of non-fatal myocardial infarction, 66% reduction in the risk of myocardial ischaemia, at the expense of a 35% increased risk of all-cause mortality and a 113% increased risk of non-fatal stroke (tables 2 and 3), which was driven mainly by the POISE trial. 6 In 14 trials, the study drug was given for more than 1 day, [3][4][5][6]22,27,28,[30][31][32][33][34][35]39 whereas the rest of the trials used the study drugs for 1 day or less. A test for interaction suggested a role of duration of β blockade for the outcome of myocardial ischaemia such that patients who received β blockade for 1 day or less had a greater decrease in the risk of myocardial ischaemia than did those who received the treatment for longer (84% vs 55% decrease; tables 2 and 3).…”

Section: Weight (%)mentioning

confidence: 99%

See 3 more Smart Citations

Perioperative β blockers in patients having non-cardiac surgery: a meta-analysis

Bangalore¹,

Wetterslev²,

Pranesh³

et al. 2008

The Lancet

333

173

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Section: Graph Marks Arrowsmentioning

confidence: 99%

“…[3][4][5][6]22,24,28,[30][31][32][33][34][35][36][37][38][39] However, the test for interaction did not show a significant effect of age category on any of the efficacy outcomes.…”

Section: Weight (%)mentioning

confidence: 99%

Section: Weight (%)mentioning

confidence: 99%

Section: Weight (%)mentioning

confidence: 99%

See 2 more Smart Citations

Perioperative β blockers in patients having non-cardiac surgery: a meta-analysis

Bangalore¹,

Wetterslev²,

Pranesh³

et al. 2008

The Lancet

333

173

View full text Add to dashboard Cite

“…89 De plus, l'incidence de fibrillation auriculaire a diminué de 40 à 67%. 90 Ainsi, le sevrage préopératoire du traitement BB chez des patients devant subir une anesthésie locoré-gionale n'est pas recommandé. Cette tolérance aux BB constatée cliniquement pourrait être expliquée par la part prépondérante des systèmes rénine et vasopressine dans la régulation de la pression artérielle sous péridurale.…”

Section: Bêta-bloquants En Anesthésie 61 Interférences Avec L'anesthunclassified

Intérêt des bêta-bloquants en médecine périopératoire. Première partie: notions fondamentales

Piriou

Aouifi

Lehot

2000

Can J Anesth/J Can Anesth

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Objectif : Rappeler les notions de pharmacologie et de physiopathologie nécessaires à l'utilisation des bêta-bloquants (BB) en médecine périopératoire.Sources : Recherche manuelle et informatisée de la littérature. (mots-clés : anesthesia and beta-blocker, surgery and beta-blocker).Constatations principales : Les BB cardiosélectifs bloquent préférentiellement les bêta-1 récepteurs, induisant une diminution de la fréquence cardiaque et de l'inotropisme, conduisant à la diminution de la consommation d'oxygène myocardique. Les BB non cardiosélectifs bloquent également les bêta-2 récepteurs, induisent une élé-vation des résistances vasculaires périphériques et bronchiques et augmentent les contractions utérines. Cependant, certains BB possèdent des effets vasodilatateurs (carvédilol, céliprolol, labétalol). Les contre-indications des BB résultent logiquement de leurs effets pharmacologiques. Le traitement BB tend à augmenter la densité des bêta-récepteurs membranaires, expliquant les manifestations d'hyperactivité du système nerveux sympathique observées lors de leur sevrage. Depuis la découverte du propranolol en 1964, les BB ont connu des fortunes diverses en anesthésie. Initialement, la sympatholyse partielle qu'ils induisent a été redoutée dans les situations de stress provoquées par les agents anesthésiques et surtout les manipulations chirurgicales. Cependant, les travaux publiés à partir de 1973 ont suggéré un effet hémodynamique protecteur. Conclusion :Les travaux récents ont démontré le caractère bénéfique de la poursuite des traitements BB jusqu'à l'anesthésie à l'exception des manifestations d'intolérance telles que l'hypotension ou la bradycardie sévère.Purpose: To review the pharmacologic and pathophysiologic information necessary to prescribe beta-blockers (BB) in perioperative medicine. Data source: Manual retrieval and electronic research of the literature using MEDLINE (key-words: anesthesia and beta-blocker; surgery and beta-blocker).Data synthesis: Cardioselective BB inhibit preferentially beta-1 receptors, inducing a decrease in heart rate and cardiac inotropism leading to reduction of oxygen myocardial consumption. Non-cardioselective BB inhibit also beta-2 receptors, increasing bronchial and peripheral vascular resistances and uterine contractions. However, some BB are also vasodilators (carvedilol, celiprolol, labetalol). Contraindications to BB result logically from their pharmacological effects. Treatment with BB increases membrane beta-receptor density; this explains sympathetic overactivity observed during weaning of treatment. Since the discovery of propranolol in 1964, the use of BB has been controversial in anesthesia. Formerly, the adverse effects of partial sympatholysis during anesthesia and surgery were feared. However, since 1973, experimental and clinical data have suggested a protective hemodynamic effect.Conclusion: Continued administration of BB up to the time of anesthesia has been encouraged except in patients with signs of intolerance such as hypotension or excessive bradyca...

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Interventions for preventing post-operative atrial fibrillation in patients undergoing heart surgery

Crystal

Garfinkle²,

Connolly³

et al. 2004

Cochrane Database of Systematic Reviews

102

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Perioperative metoprolol reduces the frequency of atrial fibrillation after thoracotomy for lung resection

Cited by 105 publications

References 25 publications

Perioperative β blockers in patients having non-cardiac surgery: a meta-analysis

Perioperative β blockers in patients having non-cardiac surgery: a meta-analysis

Intérêt des bêta-bloquants en médecine périopératoire. Première partie: notions fondamentales

Interventions for preventing post-operative atrial fibrillation in patients undergoing heart surgery

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