http://www.americanheart.org/presenter.jhtml?identifier=3051716

AHA News
11/07/2007

Beta blockers show mixed results in patients undergoing noncardiac
surgery

Beta blockers, a class of anti-ischemic drugs, might help protect
patients who are at risk for atherosclerotic cardiovascular disease
from suffering post-operative cardiovascular events, such as heart
attacks, when they undergo noncardiac surgery, according to research
reported at a late-breaking clinical trial presentation at the
American Heart Association's Scientific Sessions 2007.

The Perioperative Ischemic Evaluation (POISE) trial is the largest,
randomized controlled trial to access whether risks of post-operative
cardiovascular events can be lowered by beta
blockers..................

........Our study found strong evidence that perioperative CR
metoprolol prevents heart attacks but there is also concerning
evidence that it increases the risk of death and stroke," said P.J.
Devereaux, M.D., principal investigator of the trial and assistant
professor in the department of clinical epidemiology and biostatistics
at McMaster University in Hamilton, Ontario, Canada.  "Findings also
demonstrated that with metoprolol there was a decrease in atrial
fibrillation and in the need for coronary revascularization an
increase in clinically significant hypotension and bradycardia."

Devereaux said clinicians considering perioperative B-blocker therapy
should seek input from patients on their perspective on the trade-off
between potential benefits and harms.

Support for this study was provided by AstraZeneca

Thanks Vince