Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Khanna, AK; Naylor, DF; Naylor, AJ; Mascha, EJ; You, J; Reville, EM; Riter, QM; Diwan, M; Kurz, A; Sessler, DI.
Early Resumption of beta Blockers Is Associated with Decreased Atrial Fibrillation after Noncardiothoracic and Nonvascular Surgery A Cohort Analysis
ANESTHESIOLOGY. 2018; 129(6): 1101-1110.
Doi: 10.1097/ALN.0000000000002457
Web of Science
PubMed
FullText
FullText_MUG
- Co-authors Med Uni Graz
- Kurz Andrea
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- Abstract:
- Background: Beta (beta) blockers reduce the risk of postoperative atrial fibrillation and should be restarted after surgery, but it remains unclear when best to resume beta blockers postoperatively. The authors thus evaluated the relationship between timing of resumption of beta blockers and atrial fibrillation in patients recovering from noncardiothoracic and nonvascular surgery. Methods: The authors evaluated 8,201 adult beta-blocker users with no previous history of atrial fibrillation who stayed at least two nights after noncardiothoracic and nonvascular surgery as a retrospective observational cohort. After propensity score matching on baseline and intraoperative variables, 1,924 patients who did resume beta blockers by the end of postoperative day 1 were compared with 973 patients who had not resumed by that time on postoperative atrial fibrillation using logistic regression. A secondary matched analysis compared 3,198 patients who resumed beta blockers on the day of surgery with 3,198 who resumed thereafter. Results: Of propensity score-matched patients who resumed beta blockers by end of postoperative day 1, 4.9% (94 of 1,924) developed atrial fibrillation, compared with 7.0% (68 of 973) of those who resumed thereafter (adjusted odds ratio, 0.69; 95% CI, 0.50-0.95; P = 0.026). Patients who resumed beta blockers on day of surgery had an atrial fibrillation incidence of 4.9% versus 5.8% for those who started thereafter (odds ratio, 0.84; 95% CI, 0.67-1.04; P = 0.104). Conclusions: Resuming beta blockers in chronic users by the end of the first postoperative day may be associated with lower odds of in-hospital atrial fibrillation. However, there seems to be little advantage to restarting on the day of surgery itself.