Preoperative β-Blocker Use and Mortality and Morbidity Following CABG Surgery in North America

CONTEXT β-Blockade therapy has recently been shown to convey a survival benefit in preoperative noncardiac vascular surgical settings. The effect of preoperative β-blocker therapy on coronary artery bypass graft surgery (CABG) outcomes has not been assessed. OBJECTIVES To examine patterns of use of...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2002-05, Vol.287 (17), p.2221-2227
Main Authors: Ferguson, Jr, T. Bruce, Coombs, Laura P, Peterson, Eric D, for the Society of Thoracic Surgeons National Adult Cardiac Surgery Database
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - therapeutic use
Aged
Antiarythmic agents
Biological and medical sciences
Cardiology
Cardiovascular system
Clinical outcomes
Coronary Artery Bypass - mortality
Drug therapy
Drug Utilization - statistics & numerical data
Drug Utilization - trends
Female
Humans
Logistic Models
Male
Medical sciences
Middle Aged
Morbidity
Mortality
North America
Outcome Assessment (Health Care)
Pharmacology. Drug treatments
Postoperative Complications - epidemiology
Preoperative Care
Surgery
Survival Analysis
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Summary:CONTEXT β-Blockade therapy has recently been shown to convey a survival benefit in preoperative noncardiac vascular surgical settings. The effect of preoperative β-blocker therapy on coronary artery bypass graft surgery (CABG) outcomes has not been assessed. OBJECTIVES To examine patterns of use of preoperative β-blockers in patients undergoing isolated CABG and to determine whether use of β-blockers is associated with lower operative mortality and morbidity. DESIGN, SETTING, AND PATIENTS Observational study using the Society of Thoracic Surgeons National Adult Cardiac Surgery Database (NCD) to assess β-blocker use and outcomes among 629 877 patients undergoing isolated CABG between 1996 and 1999 at 497 US and Canadian sites. MAIN OUTCOME MEASURE Influence of β-blockers on operative mortality, examined using both direct risk adjustment and a matched-pairs analysis based on propensity for preoperative β-blocker therapy. RESULTS From 1996 to 1999, overall use of preoperative β-blockers increased from 50% to 60% in the NCD (P
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.287.17.2221