FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 341:1789-1794 December 9, 1999 Number 24 Next

	Full Text PDF Editorial by Lee, T. H. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Cardiovascular complications are the most important causes of perioperative morbidity and mortality among patients undergoing major vascular surgery.

Methods We performed a randomized, multicenter trial to assess the effect of perioperative blockade of beta-adrenergic receptors on the incidence of death from cardiac causes and nonfatal myocardial infarction within 30 days after major vascular surgery in patients at high risk for these events. High-risk patients were identified by the presence of both clinical risk factors and positive results on dobutamine echocardiography. Eligible patients were randomly assigned to receive standard perioperative care or standard care plus perioperative beta-blockade with bisoprolol.

Results A total of 1351 patients were screened, and 846 were found to have one or more cardiac risk factors. Of these 846 patients, 173 had positive results on dobutamine echocardiography. Fifty-nine patients were randomly assigned to receive bisoprolol, and 53 to receive standard care. Fifty-three patients were excluded from randomization because they were already taking a beta-blocker, and eight were excluded because they had extensive wall-motion abnormalities either at rest or during stress testing. Two patients in the bisoprolol group died of cardiac causes (3.4 percent), as compared with nine patients in the standard-care group (17 percent, P=0.02). Nonfatal myocardial infarction occurred in nine patients given standard care only (17 percent) and in none of those given standard care plus bisoprolol (P<0.001). Thus, the primary study end point of death from cardiac causes or nonfatal myocardial infarction occurred in 2 patients in the bisoprolol group (3.4 percent) and 18 patients in the standard-care group (34 percent, P<0.001).

Conclusions Bisoprolol reduces the perioperative incidence of death from cardiac causes and nonfatal myocardial infarction in high-risk patients who are undergoing major vascular surgery.

Source Information

From Erasmus Medical Center, Rotterdam, the Netherlands (D.P., E.B., J.J.B., L.L.M.V., J.R.T.C.R., H.U.); the University of Manitoba, Winnipeg, Canada (I.R.T.); University Hospital, Utrecht, the Netherlands (J.D.B.); Twee Steden Ziekenhuis, Tilburg, the Netherlands (H.F.B.); Sint Clara Ziekenhuis, Rotterdam, the Netherlands (T.-I.Y.); San Gerardo Hospital, Monza, Italy (G.T.); and Istituto di Ricovero e Cura a Carattere Scientifico Hospital, San Giovanni Rotondo, Italy (C.V.). Other authors were Paolo M. Fioretti, Ph.D., Istituto di Cardiologia, Azienda Ospedaliera, Santa Maria della Misericordia, Udine, Italy; and Bernard Paelinck, M.D., Ziekenhuis Middelheim, Antwerp, Belgium.

Address reprint requests to Dr. Poldermans at the Department of Vascular Surgery, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands, or at poldermans{at}hlkd.azr.nl.

Full Text of this Article

Related Letters:

Beta-Blockade for Patients Undergoing Vascular Surgery
Feldman T., Fusman B., McKinsey J. F., Litwack R. S., Gilligan D. M., DeGruttola V., Poldermans D., Boersma E., Thomson I. R., Lee T. H.
Extract | Full Text  
N Engl J Med 2000; 342:1051-1053, Apr 6, 2000. Correspondence

This article has been cited by other articles:

• Davies, M.R., Cousins, J. (2009). Cardiomyopathy and anaesthesia. Contin Educ Anaesth Crit Care Pain 9: 189-193 [Full Text]  
• American College of Cardiology Foundation, , American Heart Association Task Force on Practice, , American Society of Echocardiography, , American Society of Nuclear Cardiology, , Heart Rhythm Society, , Society of Cardiovascular Anesthesiologists, , Society for Cardiovascular Angiography and Interve, , Society for Vascular Medicine, , Society for Vascular Surgery, , Fleisher, L. A., Beckman, J. A., Brown, K. A., Calkins, H., Chaikof, E. L., Fleischmann, K. E., Freeman, W. K., Froehlich, J. B., Kasper, E. K., Kersten, J. R., Riegel, B., Robb, J. F. (2009). 2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery. J Am Coll Cardiol 54: e13-e118 [Full Text]  
• American College of Cardiology Foundation, , American Heart Association Task Force on Practice, , American Society of Echocardiography, , American Society of Nuclear Cardiology, , Heart Rhythm Society, , Society of Cardiovascular Anesthesiologists, , Society for Cardiovascular Angiography and Interve, , Society for Vascular Medicine, , Society for Vascular Surgery, , Fleischmann, K. E., Beckman, J. A., Buller, C. E., Calkins, H., Fleisher, L. A., Freeman, W. K., Froehlich, J. B., Kasper, E. K., Kersten, J. R., Robb, J. F., Valentine, R. J. (2009). 2009 ACCF/AHA Focused Update on Perioperative Beta Blockade. J Am Coll Cardiol 54: 2102-2128 [Full Text]  
• 2009 WRITING GROUP TO REVIEW NEW EVIDENCE AND UPDA, , Fleischmann, K. E., Beckman, J. A., Buller, C. E., Calkins, H., Fleisher, L. A., Freeman, W. K., Froehlich, J. B., Kasper, E. K., Kersten, J. R., Robb, J. F., Valentine, R. J. (2009). 2009 ACCF/AHA Focused Update on Perioperative Beta Blockade: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 120: 2123-2151 [Full Text]  
• 2007 WRITING COMMITTEE MEMBERS, , Fleisher, L. A., Beckman, J. A., Brown, K. A., Calkins, H., Chaikof, E. L., Fleischmann, K. E., Freeman, W. K., Froehlich, J. B., Kasper, E. K., Kersten, J. R., Riegel, B., Robb, J. F. (2009). 2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 120: e169-e276 [Full Text]  
• Authors/Task Force Members, , Poldermans, D., Bax, J. J., Boersma, E., De Hert, S., Eeckhout, E., Fowkes, G., Gorenek, B., Hennerici, M. G., Iung, B., Kelm, M., Kjeldsen, K. P., Kristensen, S. D., Lopez-Sendon, J., Pelosi, P., Philippe, F., Pierard, L., Ponikowski, P., Schmid, J.-P., Sellevold, O. F.M., Sicari, R., Van den Berghe, G., Vermassen, F., Additional Contributors, , Hoeks, S. E., Vanhorebeek, I., ESC Committee for Practice Guidelines (CPG), , Vahanian, A., Auricchio, A., Bax, J. J., Ceconi, C., Dean, V., Filippatos, G., Funck-Brentano, C., Hobbs, R., Kearney, P., McDonagh, T., McGregor, K., Popescu, B. A., Reiner, Z., Sechtem, U., Sirnes, P. A., Tendera, M., Vardas, P., Widimsky, P., Document Reviewers, , De Caterina, R., Agewall, S., Al Attar, N., Andreotti, F., Anker, S. D., Baron-Esquivias, G., Berkenboom, G., Chapoutot, L., Cifkova, R., Faggiano, P., Gibbs, S., Hansen, H. S., Iserin, L., Israel, C. W., Kornowski, R., Eizagaechevarria, N. M., Pepi, M., Piepoli, M., Priebe, H. J., Scherer, M., Stepinska, J., Taggart, D., Tubaro, M. (2009). Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery: The Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-cardiac Surgery of the European Society of Cardiology (ESC) and endorsed by the European Society of Anaesthesiology (ESA). Eur Heart J 30: 2769-2812 [Full Text]  
• POLDERMANS, D., DEVEREAUX, P. J. (2009). The experts debate: Perioperative beta-blockade for noncardiac surgery--proven safe or not?. Cleveland Clinic Journal of Medicine 76: S84-S92 [Abstract] [Full Text]  
• Bolliger, D., Seeberger, M. D., Filipovic, M. (2009). Pre-operative cardiac risk assessment in noncardiac surgery: are natriuretic peptides the magic bullet?. J Am Coll Cardiol 54: 1607-1608 [Full Text]  
• (2009). Feedback. Contin Educ Anaesth Crit Care Pain 9: 167-167 [Full Text]  
• Monaco, M., Stassano, P., Di Tommaso, L., Pepino, P., Giordano, A., Pinna, G. B., Iannelli, G., Ambrosio, G. (2009). Systematic strategy of prophylactic coronary angiography improves long-term outcome after major vascular surgery in medium- to high-risk patients: a prospective, randomized study.. J Am Coll Cardiol 54: 989-996 [Abstract] [Full Text]  
• Brunelli, A., Charloux, A., Bolliger, C. T., Rocco, G., Sculier, J-P., Varela, G., Licker, M., Ferguson, M. K., Faivre-Finn, C., Huber, R. M., Clini, E. M., Win, T., De Ruysscher, D., Goldman, L., on behalf of the European Respiratory Society and, (2009). ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy). Eur Respir J 34: 17-41 [Abstract] [Full Text]  
• Brooke, B. S., Dominici, F., Makary, M. A., Pronovost, P. J. (2009). Use Of Beta-Blockers During Aortic Aneurysm Repair: Bridging The Gap Between Evidence And Effective Practice. Health Aff (Millwood) 28: 1199-1209 [Abstract] [Full Text]  
• Talati, R., Reinhart, K. M, White, C M., Phung, O. J, Sedrakyan, A., Kluger, J., Coleman, C. I (2009). Outcomes of Perioperative {beta}-Blockade in Patients Undergoing Noncardiac Surgery: A Meta-Analysis. The Annals of Pharmacotherapy 43: 1181-1188 [Abstract] [Full Text]  
• Landesberg, G., Beattie, W. S., Mosseri, M., Jaffe, A. S., Alpert, J. S. (2009). Perioperative Myocardial Infarction. Circulation 119: 2936-2944 [Full Text]  
• Suttner, S., Boldt, J., Mengistu, A., Lang, K., Mayer, J. (2009). Influence of continuous perioperative beta-blockade in combination with phosphodiesterase inhibition on haemodynamics and myocardial ischaemia in high-risk vascular surgery patients. Br J Anaesth 102: 597-607 [Abstract] [Full Text]  
• Wijeysundera, D. N., Austin, P. C., Beattie, W. S., Hux, J. E., Laupacis, A. (2009). A Population-Based Study of Anesthesia Consultation Before Major Noncardiac Surgery. Arch Intern Med 169: 595-602 [Abstract] [Full Text]  
• Poldermans, D., Schouten, O., Bax, J., Winkel, T. A. (2009). Reducing cardiac risk in non-cardiac surgery: evidence from the DECREASE studies. Eur Heart J Suppl 11: A9-A14 [Abstract] [Full Text]  
• Kaafarani, H. M. A., Atluri, P. V., Thornby, J., Itani, K. M. F. (2008). {beta}-Blockade in Noncardiac Surgery: Outcome at All Levels of Cardiac Risk. Arch Surg 143: 940-944 [Abstract] [Full Text]  
• Kertai, M. D., Westerhout, C. M., Varga, K. S., Acsady, G., Gal, J. (2008). Dihydropiridine calcium-channel blockers and perioperative mortality in aortic aneurysm surgery. Br J Anaesth 101: 458-465 [Abstract] [Full Text]  
• van Gestel, Y. R. B. M., Hoeks, S. E., Sin, D. D., Welten, G. M. J. M., Schouten, O., Witteveen, H. J., Simsek, C., Stam, H., Mertens, F. W., Bax, J. J., van Domburg, R. T., Poldermans, D. (2008). Impact of Cardioselective {beta}-Blockers on Mortality in Patients with Chronic Obstructive Pulmonary Disease and Atherosclerosis. Am. J. Respir. Crit. Care Med. 178: 695-700 [Abstract] [Full Text]  
• FELDMAN, L. S., BROTMAN, D. J. (2008). Perioperative statins: More than lipid-lowering?. Cleveland Clinic Journal of Medicine 75: 654-662 [Abstract] [Full Text]  
• Auerbach, A. D. (2008). Changing the Practice of Perioperative Cardioprotection: Perioperative {beta}-Blockers After POISE (PeriOperative ISchemic Evaluation). Circ Cardiovasc Qual Outcomes 1: 58-61 [Full Text]  
• Slovut, D. P., Sullivan, T. M (2008). Critical limb ischemia: medical and surgical management. Vasc Med 13: 281-291 [Abstract]  
• Sear, J. W., Giles, J. W., Howard-Alpe, G., Foex, P. (2008). Perioperative beta-blockade, 2008: What does POISE tell us, and was our earlier caution justified?. Br J Anaesth 101: 135-138 [Full Text]  
• HARTE, B., JAFFER, A. K. (2008). Perioperative beta-blockers in noncardiac surgery: Evolution of the evidence. Cleveland Clinic Journal of Medicine 75: 513-519 [Abstract] [Full Text]  
• Matyal, R. (2008). Newly Appreciated Pathophysiology of Ischemic Heart Disease in Women Mandates Changes in Perioperative Management: A Core Review. Anesth. Analg. 107: 37-50 [Abstract] [Full Text]  
• Fisher, B. W., Ramsay, G., Majumdar, S. R., Hrazdil, C. T., Finegan, B. A., Padwal, R. S., McAlister, F. A. (2008). The Ankle-to-Arm Blood Pressure Index Predicts Risk of Cardiac Complications After Noncardiac Surgery. Anesth. Analg. 107: 149-154 [Abstract] [Full Text]  
• Sicari, R., Nihoyannopoulos, P., Evangelista, A., Kasprzak, J., Lancellotti, P., Poldermans, D., Voigt, J.-U., Zamorano, J. L., on behalf of the European Association of Echocardi, (2008). Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC). Eur J Echocardiogr 9: 415-437 [Abstract] [Full Text]  
• Brett, A. S. (2008). Coronary Assessment Before Noncardiac Surgery: Current Strategies Are Flawed. Circulation 117: 3145-3151 [Full Text]  
• Poldermans, D., Hoeks, S. E., Feringa, H. H. (2008). Pre-Operative Risk Assessment and Risk Reduction Before Surgery. J Am Coll Cardiol 51: 1913-1924 [Abstract] [Full Text]  
• Welten, G. M.J.M., Schouten, O., Hoeks, S. E., Chonchol, M., Vidakovic, R., van Domburg, R. T., Bax, J. J., van Sambeek, M. R.H.M., Poldermans, D. (2008). Long-term prognosis of patients with peripheral arterial disease: a comparison in patients with coronary artery disease.. J Am Coll Cardiol 51: 1588-1596 [Abstract] [Full Text]  
• London, M. J. (2008). Quo Vadis, Perioperative Beta Blockade? Are You "POISE'd" on the Brink?. Anesth. Analg. 106: 1025-1030 [Full Text]  
• Mittnacht, A. J., Fanshawe, M., Konstadt, S. (2008). Anesthetic Considerations in the Patient With Valvular Heart Disease Undergoing Noncardiac Surgery. SEMIN CARDIOTHORAC VASC ANESTH 12: 33-59 [Abstract]  
• Kertai, M. D. (2008). Preoperative Coronary Revascularization in High-Risk Patients Undergoing Vascular Surgery: A Core Review. Anesth. Analg. 106: 751-758 [Abstract] [Full Text]  
• Garcia, S., McFalls, E. O. (2008). CON: Preoperative Coronary Revascularization in High-Risk Patients Undergoing Vascular Surgery. Anesth. Analg. 106: 764-766 [Full Text]  
• Xu-Cai, Y. O., Brotman, D. J., Phillips, C. O., Michota, F. A., Tang, W. H. W., Whinney, C. M., Panneerselvam, A., Hixson, E. D., Garcia, M., Francis, G. S., Jaffer, A. K. (2008). Outcomes of Patients With Stable Heart Failure Undergoing Elective Noncardiac Surgery. Mayo Clin Proc. 83: 280-288 [Abstract] [Full Text]  
• McFalls, E. O., Ward, H. B., Moritz, T. E., Apple, F. S., Goldman, S., Pierpont, G., Larsen, G. C., Hattler, B., Shunk, K., Littooy, F., Santilli, S., Rapp, J., Thottapurathu, L., Krupski, W., Reda, D. J., Henderson, W. G. (2008). Predictors and outcomes of a perioperative myocardial infarction following elective vascular surgery in patients with documented coronary artery disease: results of the CARP trial. Eur Heart J 29: 394-401 [Abstract] [Full Text]  
• Siracusano, L., Girasole, V., Piriou, V., Mantz, J. (2008). Sevoflurane and cardioprotection. Br J Anaesth 100: 278-279 [Full Text]  
• Wilcox, R. A., Djulbegovic, B., Guyatt, G. H., Montori, V. M. (2008). Randomized Trials in Oncology Stopped Early for Benefit. JCO 26: 18-19 [Full Text]  
• Levy, J. H., Tanaka, K. A., Bailey, J. M. (2008). Cardiac Surgical Pharmacology. Card Surg Adult 3: 77-110 [Full Text]  
• Biccard, B. M., Sear, J. W., Foex, P. (2008). Meta-analysis of the effect of heart rate achieved by perioperative beta-adrenergic blockade on cardiovascular outcomes. Br J Anaesth 100: 23-28 [Abstract] [Full Text]  
• Walsh, S. R., Tang, T., Sadat, U., Dutka, D. P., Gaunt, M. E. (2007). Cardioprotection by remote ischaemic preconditioning. Br J Anaesth 99: 611-616 [Abstract] [Full Text]  
• Fleisher, L. A., Beckman, J. A., Brown, K. A., Calkins, H., Chaikof, E. L., Fleischmann, K. E., Freeman, W. K., Froehlich, J. B., Kasper, E. K., Kersten, J. R., Riegel, B., Robb, J. F., Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Buller, C. E., Creager, M. A., Ettinger, S. M., Faxon, D. P., Fuster, V., Halperin, J. L., Hiratzka, L. F., Hunt, S. A., Lytle, B. W., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B., Tarkington, L. G., Yancy, C. W. (2007). ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Developed in Collaboration With the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery. J Am Coll Cardiol 50: e159-e242 [Full Text]  
• Fleisher, L. A., Beckman, J. A., Brown, K. A., Calkins, H., Chaikof, E. L., Fleischmann, K. E., Freeman, W. K., Froehlich, J. B., Kasper, E. K., Kersten, J. R., Riegel, B., Robb, J. F. (2007). ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Circulation 116: e418-e500 [Full Text]  
• Chassot, P.-G., Delabays, A., Spahn, D. R. (2007). Perioperative antiplatelet therapy: the case for continuing therapy in patients at risk of myocardial infarction. Br J Anaesth 99: 316-328 [Abstract] [Full Text]  
• Iida, R., Iwasaki, K.-i., Kato, J., Saeki, S., Ogawa, S. (2007). Reflex Sympathetic Activity After Intravenous Administration of Midazolam in Anesthetized Cats. Anesth. Analg. 105: 832-837 [Abstract] [Full Text]  
• Cohn, S. L., Smetana, G. W. (2007). Update in Perioperative Medicine. ANN INTERN MED 147: 263-270 [Full Text]  
• Mohler, E. R. III, Mantha, S., Miller, A. B., Poldermans, D., Cropp, A. B., Aubin, L. B. St., Billing, C. B. JR, Fleisher, L. A. (2007). Should troponin and creatinine kinase be routinely measured after vascular surgery?. Vasc Med 12: 175-181 [Abstract]  
• Cuthbertson, B. H., Amiri, A. R., Croal, B. L., Rajagopalan, S., Alozairi, O., Brittenden, J., Hillis, G. S. (2007). Utility of B-type natriuretic peptide in predicting perioperative cardiac events in patients undergoing major non-cardiac surgery. Br J Anaesth 99: 170-176 [Abstract] [Full Text]  
• Ishikawa, S. (2007). There Are More Important Risk Factors That May Influence The Outcome in Female AVR Patients. Anesth. Analg. 105: 541-542 [Full Text]  
• Mueller, P. S., Montori, V. M., Bassler, D., Koenig, B. A., Guyatt, G. H. (2007). Ethical Issues in Stopping Randomized Trials Early Because of Apparent Benefit. ANN INTERN MED 146: 878-881 [Abstract] [Full Text]  
• Ong, H T (2007). beta blockers in hypertension and cardiovascular disease. BMJ 334: 946-949 [Full Text]  
• Landesberg, G., Berlatzky, Y., Bocher, M., Alcalai, R., Anner, H., Ganon-Rozental, T., Luria, M. H., Akopnik, I., Weissman, C., Mosseri, M. (2007). A clinical survival score predicts the likelihood to benefit from preoperative thallium scanning and coronary revascularization before major vascular surgery. Eur Heart J 28: 533-539 [Abstract] [Full Text]  
• Feringa, H. H H, Schouten, O., Dunkelgrun, M., Bax, J. J, Boersma, E., Elhendy, A., de Jonge, R., Karagiannis, S. E, Vidakovic, R., Poldermans, D. (2007). Plasma N-terminal pro-B-type natriuretic peptide as long-term prognostic marker after major vascular surgery. Heart 93: 226-231 [Abstract] [Full Text]  
• Authors/Task Force Members, , Vahanian, A., Baumgartner, H., Bax, J., Butchart, E., Dion, R., Filippatos, G., Flachskampf, F., Hall, R., Iung, B., Kasprzak, J., Nataf, P., Tornos, P., Torracca, L., Wenink, A., ESC Committee for Practice Guidelines (CPG), , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, J., Dean, V., Deckers, J., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J., Zamorano, J. L., Document Reviewers, , Zamorano, J. L., Angelini, A., Antunes, M., Fernandez, M. A. G., Gohlke-Baerwolf, C., Habib, G., McMurray, J., Otto, C., Pierard, L., Pomar, J. L., Prendergast, B., Rosenhek, R., Uva, M. S., Tamargo, J. (2007). Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J 0: ehl428v1-39 [Full Text]  
• Schouten, O., Bax, J. J., Dunkelgrun, M., Feringa, H. H.H., Poldermans, D. (2007). Pro: Beta-Blockers Are Indicated for Patients at Risk for Cardiac Complications Undergoing Noncardiac Surgery. Anesth. Analg. 104: 8-10 [Full Text]  
• London, M. J. (2007). Con: Beta-Blockers Are Indicated for All Adults at Increased Risk Undergoing Noncardiac Surgery. Anesth. Analg. 104: 11-14 [Full Text]  
• Wiesbauer, F., Schlager, O., Domanovits, H., Wildner, B., Maurer, G., Muellner, M., Blessberger, H., Schillinger, M. (2007). Perioperative {beta}-Blockers for Preventing Surgery-Related Mortality and Morbidity: A Systematic Review and Meta-Analysis. Anesth. Analg. 104: 27-41 [Abstract] [Full Text]  
• Sugiura, S., Seki, S., Hidaka, K., Masuoka, M., Tsuchida, H. (2007). The Hemodynamic Effects of Landiolol, an Ultra-Short-Acting {beta}1-Selective Blocker, on Endotracheal Intubation in Patients With and Without Hypertension. Anesth. Analg. 104: 124-129 [Abstract] [Full Text]  
• Howard-Alpe, G. M., Sear, J. W., Foex, P. (2006). Methods of detecting atherosclerosis in non-cardiac surgical patients; the role of biochemical markers. Br J Anaesth 97: 758-769 [Abstract] [Full Text]  
• Schouten, O., Bax, J. J, Poldermans, D. (2006). Assessment of cardiac risk before non-cardiac general surgery. Heart 92: 1866-1872 [Full Text]  
• Eagle, K. A., Lau, W. C. (2006). Any Need for Preoperative Cardiac Testing in Intermediate-Risk Patients With Tight Beta-Adrenergic Blockade?. J Am Coll Cardiol 48: 970-972 [Full Text]  
• Poldermans, D., Bax, J. J., Schouten, O., Neskovic, A. N., Paelinck, B., Rocci, G., van Dortmont, L., Durazzo, A. E.S., van de Ven, L. L.M., van Sambeek, M. R.H.M., Kertai, M. D., Boersma, E., for the Dutch Echocardiographic Cardiac Risk Evalu, (2006). Should Major Vascular Surgery Be Delayed Because of Preoperative Cardiac Testing in Intermediate-Risk Patients Receiving Beta-Blocker Therapy With Tight Heart Rate Control?. J Am Coll Cardiol 48: 964-969 [Abstract] [Full Text]  
• Ward, H. B., Kelly, R. F., Thottapurathu, L., Moritz, T. E., Larsen, G. C., Pierpont, G., Santilli, S., Goldman, S., Krupski, W. C., Littooy, F., Reda, D. J., McFalls, E. O. (2006). Coronary artery bypass grafting is superior to percutaneous coronary intervention in prevention of perioperative myocardial infarctions during subsequent vascular surgery.. Ann. Thorac. Surg. 82: 795-800 [Abstract] [Full Text]  
• Adesanya, A. O., de Lemos, J. A., Greilich, N. B., Whitten, C. W. (2006). Management of perioperative myocardial infarction in noncardiac surgical patients.. Chest 130: 584-596 [Abstract] [Full Text]  
• Feringa, H. H.H., Bax, J. J., Boersma, E., Kertai, M. D., Meij, S. H., Galal, W., Schouten, O., Thomson, I. R., Klootwijk, P., van Sambeek, M. R.H.M., Klein, J., Poldermans, D. (2006). High-Dose {beta}-Blockers and Tight Heart Rate Control Reduce Myocardial Ischemia and Troponin T Release in Vascular Surgery Patients. Circulation 114: I-344-I-349 [Abstract] [Full Text]  
• Tote, S. P., Grounds, R. M. (2006). Performing perioperative optimization of the high-risk surgical patient. Br J Anaesth 97: 4-11 [Abstract] [Full Text]  
• Moretti, E. W., Newman, M. F., Muhlbaier, L. H., Whellan, D., Petersen, R. P., Rossignol, D., McCants, C. B. Jr, Phillips-Bute, B., Bennett-Guerrero, E. (2006). Effects of Decreased Preoperative Endotoxin Core Antibody Levels on Long-term Mortality After Coronary Artery Bypass Graft Surgery. Arch Surg 141: 637-641 [Abstract] [Full Text]  
• Juul, A. B., Wetterslev, J., Gluud, C., Kofoed-Enevoldsen, A., Jensen, G., Callesen, T., Norgaard, P., Fruergaard, K., Bestle, M., Vedelsdal, R., Miran, A., Jacobsen, J., Roed, J., Mortensen, M.-B., Jorgensen, L., Jorgensen, J., Rovsing, M.-L., Petersen, P. L., Pott, F., Haas, M., Albret, R., Nielsen, L. L., Johansson, G., Stjernholm, P., Molgaard, Y., Foss, N. B., Elkjaer, J., Dehlie, B., Boysen, K., Zaric, D., Munksgaard, A., Madsen, J. B., Oberg, B., Khanykin, B., Blemmer, T., Yndgaard, S., Perko, G., Wang, L. P., Winkel, P., Hilden, J., Jensen, P., Salas, N., DIPOM Trial Group, (2006). Effect of perioperative beta blockade in patients with diabetes undergoing major non-cardiac surgery: randomised placebo controlled, blinded multicentre trial.. BMJ 332: 1482-1482 [Abstract] [Full Text]  
• Fleisher, L. A., Beckman, J. A., Brown, K. A., Calkins, H., Chaikof, E., Fleischmann, K. E., Freeman, W. K., Froehlich, J. B., Kasper, E. K., Kersten, J. R., Riegel, B., Robb, J. F., Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Faxon, D. P., Fuster, V., Halperin, J. L., Hiratzka, L. F., Hunt, S. A., Lytle, B. W., Nishimura, R., Page, R. L., Riegel, B. (2006). ACC/AHA 2006 Guideline Update on Perioperative Cardiovascular Evaluation for Noncardiac Surgery: Focused Update on Perioperative Beta-Blocker Therapy: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Developed in Collaboration With the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society for Vascular Medicine and Biology. J Am Coll Cardiol 47: 2343-2355 [Full Text]  
• Auerbach, A., Goldman, L. (2006). Assessing and Reducing the Cardiac Risk of Noncardiac Surgery. Circulation 113: 1361-1376 [Full Text]  
• London, M. J. (2006). Beta-Blockade in the Perioperative Period: Where Do We Stand After All the Trials?. SEMIN CARDIOTHORAC VASC ANESTH 10: 17-23 [Abstract]  
• Feringa, H. H. H., Bax, J. J., Schouten, O., Poldermans, D. (2006). Protecting the Heart with Cardiac Medication in Patients with Left Ventricular Dysfunction Undergoing Major Noncardiac Vascular Surgery. SEMIN CARDIOTHORAC VASC ANESTH 10: 25-31 [Abstract]  
• Karthikeyan, G, Bhargava, B (2006). Managing patients undergoing non-cardiac surgery: need to shift emphasis from risk stratification to risk modification. Heart 92: 17-20 [Abstract] [Full Text]  
• Cunningham, L. D., Conte, M. S. (2005). Lower-Extremity Arterial Disease. PERSPECT VASC SURG ENDOVASC THER 17: 351-361 [Abstract]  
• (2005). Additional Information. JAMA 294: E1-E3 [Full Text]  
• Montori, V. M., Devereaux, P. J., Adhikari, N. K. J., Burns, K. E. A., Eggert, C. H., Briel, M., Lacchetti, C., Leung, T. W., Darling, E., Bryant, D. M., Bucher, H. C., Schunemann, H. J., Meade, M. O., Cook, D. J., Erwin, P. J., Sood, A., Sood, R., Lo, B., Thompson, C. A., Zhou, Q., Mills, E., Guyatt, G. H. (2005). Randomized Trials Stopped Early for Benefit: A Systematic Review. JAMA 294: 2203-2209 [Abstract] [Full Text]  
• Hoeks, S. E., Bax, J. J., Poldermans, D. (2005). Should the ACC/AHA guidelines be changed in patients undergoing vascular surgery?. Eur Heart J 26: 2358-2360 [Full Text]  
• Redelmeier, D., Scales, D., Kopp, A. (2005). {beta} blockers for elective surgery in elderly patients: population based, retrospective cohort study. BMJ 331: 932- [Abstract] [Full Text]  
• Kent, D. M. (2005). Improved Perioperative Outcomes From Carotid Endarterectomy: Yet Another Statin Side Effect?. Stroke 36: 2058-2059 [Full Text]  
• Kennedy, J., Quan, H., Buchan, A. M., Ghali, W. A., Feasby, T. E. (2005). Statins Are Associated With Better Outcomes After Carotid Endarterectomy in Symptomatic Patients. Stroke 36: 2072-2076 [Abstract] [Full Text]  
• Devereaux, P.J., Goldman, L., Yusuf, S., Gilbert, K., Leslie, K., Guyatt, G. H. (2005). Surveillance and prevention of major perioperative ischemic cardiac events in patients undergoing noncardiac surgery: a review. CMAJ 173: 779-788 [Abstract] [Full Text]  
• Edmonds, M. (2005). Infection in the Neuroischemic Foot. INT J LOW EXTREM WOUNDS 4: 145-153 [Abstract]  
• Devereaux, P J, Beattie, W S., Choi, P. T-L, Badner, N. H, Guyatt, G. H, Villar, J. C, Cina, C. S, Leslie, K., Jacka, M. J, Montori, V. M, Bhandari, M., Avezum, A., Cavalcanti, A. B, Giles, J. W, Schricker, T., Yang, H., Jakobsen, C.-J., Yusuf, S. (2005). How strong is the evidence for the use of perioperative {beta} blockers in non-cardiac surgery? Systematic review and meta-analysis of randomised controlled trials. BMJ 331: 313-321 [Abstract] [Full Text]  
• Lindenauer, P. K., Pekow, P., Wang, K., Mamidi, D. K., Gutierrez, B., Benjamin, E. M. (2005). Perioperative Beta-Blocker Therapy and Mortality after Major Noncardiac Surgery. NEJM 353: 349-361 [Abstract] [Full Text]  
• Poldermans, D., Boersma, E. (2005). Beta-Blocker Therapy in Noncardiac Surgery. NEJM 353: 412-414 [Full Text]  
• Priebe, H.-J. (2005). Perioperative myocardial infarction--aetiology and prevention. Br J Anaesth 95: 3-19 [Abstract] [Full Text]  
• Egred, M., Shaw, S., Mohammad, B., Waitt, P., Rodrigues, E. (2005). Under-use of beta-blockers in patients with ischaemic heart disease and concomitant chronic obstructive pulmonary disease. QJM 98: 493-497 [Abstract] [Full Text]