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

Volume 335:1713-1721 December 5, 1996 Number 23 Next

	Full Text PDF Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article PubMed Citation

ABSTRACT

Background Perioperative myocardial ischemia is the single most important potentially reversible risk factor for mortality and cardiovascular complications after noncardiac surgery. Although more than 1 million patients have such complications annually, there is no effective preventive therapy.

Methods We performed a randomized, double-blind, placebo-controlled trial to compare the effect of atenolol with that of a placebo on overall survival and cardiovascular morbidity in patients with or at risk for coronary artery disease who were undergoing noncardiac surgery. Atenolol was given intravenously before and immediately after surgery and orally thereafter for the duration of hospitalization. Patients were followed over the subsequent two years.

Results A total of 200 patients were enrolled. Ninety-nine were assigned to the atenolol group, and 101 to the placebo group. One hundred ninety-four patients survived to be discharged from the hospital, and 192 of these were followed for two years. Overall mortality after discharge from the hospital was significantly lower among the atenolol-treated patients than among those who were given placebo over the six months following hospital discharge (0 vs. 8 percent, P<0.001), over the first year (3 percent vs. 14 percent, P = 0.005), and over two years (10 percent vs. 21 percent, P = 0.019). The principal effect was a reduction in deaths from cardiac causes during the first six to eight months. Combined cardiovascular outcomes were similarly reduced among the atenolol-treated patients; event-free survival throughout the two-year study period was 68 percent in the placebo group and 83 percent in the atenolol group (P = 0.008).

Conclusions In patients who have or are at risk for coronary artery disease who must undergo noncardiac surgery, treatment with atenolol during hospitalization can reduce mortality and the incidence of cardiovascular complications for as long as two years after surgery.

Source Information

From the San Francisco Veterans Affairs Medical Center and University of California, San Francisco (D.T.M., A.W.), and the Ischemia Research and Education Foundation, San Francisco (E.L.L., I.T.).

Address reprint requests to Dr. Mangano at the San Francisco Veterans Affairs Medical Center, 4150 Clement St., 129, San Francisco, CA 94121.

Full Text of this Article

Related Letters:

Effect of Atenolol on Mortality and Cardiovascular Morbidity after Noncardiac Surgery
Petros J. A., Ho T., Taussig D., McAnulty G., Devereaux P.J., Ghali W. A., Reis S. E., Feldman A. H., Mangano D. T.
Extract | Full Text  
N Engl J Med 1997; 336:1452-1454, May 15, 1997. Correspondence

This article has been cited by other articles:

• Domanski, D., Schwarz, E. R. (2009). Clinical Review: Is the Perioperative Use of {beta}-Blockers Still Recommended? A Critical Review of Recent Controversies. J CARDIOVASC PHARMACOL THER 14: 258-268 [Abstract]  
• 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]  
• (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]  
• Ausset, S., Minville, V., Marquis, C., Fourcade, O., Rosencher, N., Benhamou, D., Auroy, Y. (2009). Postoperative myocardial damages after hip fracture repair are frequent and associated with a poor cardiac outcome: a three-hospital study. Age Ageing 38: 473-476 [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]  
• Hoeks, S. E., Scholte op Reimer, W. J.M., van Gestel, Y. R.B.M., Schouten, O., Lenzen, M. J., Flu, W.-J., van Kuijk, J.-P., Latour, C., Bax, J. J., van Urk, H., Poldermans, D. (2009). Medication Underuse During Long-Term Follow-Up in Patients With Peripheral Arterial Disease. Circ Cardiovasc Qual Outcomes 2: 338-343 [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]  
• Stone, J. G., Khambatta, H. J., Sear, J. W., Foex, P. (2009). Beta-Blockers: Must We Throw the Baby Out with the Bath Water?. Anesth. Analg. 108: 1987-1990 [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]  
• Huffmyer, J., Raphael, J. (2009). Physiology and Pharmacology of Myocardial Preconditioning and Postconditioning. SEMIN CARDIOTHORAC VASC ANESTH 13: 5-18 [Abstract]  
• Hoeks, S., Poldermans, D. (2009). CHAPTER 34 Non-cardiac Surgery in Cardiac Patients. ESC Textbook of Cardiovascular Medicine 2: med-9780199566990-chapter-med-9780199566990-chapter [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]  
• Gregoratos, G. (2008). Current Guideline-Based Preoperative Evaluation Provides the Best Management of Patients Undergoing Noncardiac Surgery. Circulation 117: 3134-3144 [Full Text]  
• Brett, A. S. (2008). Coronary Assessment Before Noncardiac Surgery: Current Strategies Are Flawed. Circulation 117: 3145-3151 [Full Text]  
• Aboyans, V., Frank, M., Nubret, K., Lacroix, P., Laskar, M. (2008). Heart rate and pulse pressure at rest are major prognostic markers of early postoperative complications after coronary bypass surgery. Eur. J. Cardiothorac. Surg. 33: 971-976 [Abstract] [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]  
• Baumert, J.-H., Hein, M., Hecker, K. E., Satlow, S., Neef, P., Rossaint, R. (2008). Xenon or propofol anaesthesia for patients at cardiovascular risk in non-cardiac surgery. Br J Anaesth 100: 605-611 [Abstract] [Full Text]  
• Dransfield, M T, Rowe, S M, Johnson, J E, Bailey, W C, Gerald, L B (2008). Use of {beta} blockers and the risk of death in hospitalised patients with acute exacerbations of COPD. Thorax 63: 301-305 [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]  
• 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]  
• Levy, J. H., Tanaka, K. A., Bailey, J. M. (2008). Cardiac Surgical Pharmacology. Card Surg Adult 3: 77-110 [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]  
• Perler, B. A. (2007). Should Statins Be Given Routinely Before Carotid Endarterectomy?. PERSPECT VASC SURG ENDOVASC THER 19: 240-245 [Abstract]  
• Reich, D. L., Fischer, G. W. (2007). Perioperative Interventions to Modify Risk of Morbidity and Mortality. SEMIN CARDIOTHORAC VASC ANESTH 11: 224-230 [Abstract]  
• 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]  
• 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]  
• Bolsin, S., Colson, M., Conroy, M. (2007). beta blockers and statins in non-cardiac surgery. BMJ 334: 1283-1284 [Full Text]  
• Baumert, J.-H., Hein, M., Hecker, K. E., Satlow, S., Schnoor, J., Rossaint, R. (2007). Autonomic cardiac control with xenon anaesthesia in patients at cardiovascular risk. Br J Anaesth 98: 722-727 [Abstract] [Full Text]  
• Pirracchio, R., Cholley, B., De Hert, S., Solal, A. C., Mebazaa, A. (2007). Diastolic heart failure in anaesthesia and critical care. Br J Anaesth 98: 707-721 [Abstract] [Full Text]  
• Le Manach, Y., Godet, G., Coriat, P., Martinon, C., Bertrand, M., Fleron, M.-H., Riou, B. (2007). The Impact of Postoperative Discontinuation or Continuation of Chronic Statin Therapy on Cardiac Outcome After Major Vascular Surgery. Anesth. Analg. 104: 1326-1333 [Abstract] [Full Text]  
• Chaturvedi, S. (2007). Should Stroke Be Considered Both a Brain Attack and a Heart Attack?. Stroke 38: 1713-1714 [Full Text]  
• Moscucci, M., Jones, N. (2007). Coronary Revascularization Before Noncardiac Vascular Surgery: One More Step Forward in Understanding Its Role. J Am Coll Cardiol 49: 1770-1771 [Full Text]  
• Bresnahan, S., Eastwood, J.-A. (2007). Confounding T-Wave Inversion. Am J Crit Care 16: 137-140 [Abstract] [Full Text]  
• Mangano, D. T., Miao, Y., Vuylsteke, A., Tudor, I. C., Juneja, R., Filipescu, D., Hoeft, A., Fontes, M. L., Hillel, Z., Ott, E., Titov, T., Dietzel, C., Levin, J., for the Investigators of The Multicenter Study of, (2007). Mortality Associated With Aprotinin During 5 Years Following Coronary Artery Bypass Graft Surgery. JAMA 297: 471-479 [Abstract] [Full Text]  
• Fleisher, L. A. (2007). Perioperative {beta}-Blockade: How Best to Translate Evidence into Practice. Anesth. Analg. 104: 1-3 [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]  
• Sidi, A., Muehlschlegel, J. D., Kirby, D. S., Lobato, E. B. (2006). Treatment of ischaemic left ventricular dysfunction with milrinone or dobutamine administered during coronary artery stenosis in the presence of beta blockade in pigs. Br J Anaesth 97: 799-807 [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]  
• 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]  
• Hanss, R., Bein, B., Turowski, P., Cavus, E., Bauer, M., Andretzke, M., Steinfath, M., Scholz, J., Tonner, P. H. (2006). The influence of xenon on regulation of the autonomic nervous system in patients at high risk of perioperative cardiac complications. Br J Anaesth 96: 427-436 [Abstract] [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]  
• 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]  
• Scarlett, J., Hahn, N., Jacobsohn, E., Avidan, M. S. (2005). The Evidence That Deep Anesthesia Impacts Long Term Mortality Is Not Compelling. Anesth. Analg. 101: 1880-1880 [Full Text]  
• Bursi, F., Babuin, L., Barbieri, A., Politi, L., Zennaro, M., Grimaldi, T., Rumolo, A., Gargiulo, M., Stella, A., Modena, M. G., Jaffe, A. S. (2005). Vascular surgery patients: perioperative and long-term risk according to the ACC/AHA guidelines, the additive role of post-operative troponin elevation. Eur Heart J 26: 2448-2456 [Abstract] [Full Text]  
• Thielmann, M., Massoudy, P., Schmermund, A., Neuhauser, M., Marggraf, G., Kamler, M., Herold, U., Aleksic, I., Mann, K., Haude, M., Heusch, G., Erbel, R., Jakob, H. (2005). Diagnostic discrimination between graft-related and non-graft-related perioperative myocardial infarction with cardiac troponin I after coronary artery bypass surgery. Eur Heart J 26: 2440-2447 [Abstract] [Full Text]  
• Bolsin, S., Colson, M. (2005). {beta} blockers for patients at risk of cardiac events during non-cardiac surgery. BMJ 331: 919-920 [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]  
• Alibhai, S. M. H., Leach, M., Tomlinson, G., Krahn, M. D., Fleshner, N., Holowaty, E., Naglie, G. (2005). 30-Day Mortality and Major Complications after Radical Prostatectomy: Influence of Age and Comorbidity. JNCI J Natl Cancer Inst 97: 1525-1532 [Abstract] [Full Text]  
• Christ, M., Sharkova, Y., Geldner, G., Maisch, B. (2005). Preoperative and Perioperative Care for Patients With Suspected or Established Aortic Stenosis Facing Noncardiac Surgery. Chest 128: 2944-2953 [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]  
• 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]