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Short-term effects of preoperative beta-blocker use for isolated coronary artery bypass grafting: A systematic review and meta-analysis

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机构: [1]Center for Cardiac Intensive Care, Capital Medical University Affiliated Anzhen Hospital, Beijing, People’s Republic of China
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关键词: coronary artery bypass grafting operative mortality perioperative beta-blocker use

摘要:
Objective: The use of preoperative beta-blockers has been used as a quality standard for patients undergoing coronary artery bypass grafting (CABG). However, the benefits of beta-blockers use before CABG remain controversial. We performed a systematic review and meta-analysis to investigate the short-term effects of preoperative beta-blocker use for patients undergoing isolated CABG. Methods: We searched PubMed, Embase, and the Cochrane Library for English articles published from inception to August 16, 2016. Observational studies comparing preoperative beta-blockers therapy or non-beta-blockers therapy were considered eligible for the current study. Results: Six observational studies with 1,231,850 patients were included. The pooled analyses of unadjusted outcome (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.71-0.95; P =.007) or risk-adjusted outcome (OR, 0.95; 95% CI, 0.92-0.97; P =.000) showed slight reduction in operative mortality, whereas an insignificant difference in mortality rate was observed in pooling postoperative data from propensity score analysis (OR, 0.97; 95% CI, 0.94-1.00; P =.088). Removing one study that used propensity-score covariate adjustment, subgroup analysis of propensity-matched patients (313,417 in each group) still generated a statistically nonsignificant benefit for preoperative beta-blocker use (OR, 0.97; 95% CI, 0.94-1.00; P =.093). Furthermore, the preoperative use of beta-blockers did not reduce the incidence of major postoperative complications, such as postoperative myocardial infarction, stroke, atrial fibrillation, reoperation, renal failure, prolonged ventilation, and sternal wound infection. Conclusions: Our study suggests that the use of preoperative beta-blockers did not reduce either operative mortality or the incidence of postoperative complications in patients undergoing CABG.

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出版当年[2017]版:
大类 | 2 区 医学
小类 | 2 区 呼吸系统 2 区 外科 3 区 心脏和心血管系统
最新[2023]版:
大类 | 1 区 医学
小类 | 1 区 外科 2 区 心脏和心血管系统 2 区 呼吸系统
JCR分区:
出版当年[2016]版:
Q1 SURGERY Q1 RESPIRATORY SYSTEM Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Q1 RESPIRATORY SYSTEM Q1 SURGERY

影响因子: 最新[2023版] 最新五年平均 出版当年[2016版] 出版当年五年平均 出版前一年[2015版] 出版后一年[2017版]

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第一作者机构: [1]Center for Cardiac Intensive Care, Capital Medical University Affiliated Anzhen Hospital, Beijing, People’s Republic of China
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通讯机构: [1]Center for Cardiac Intensive Care, Capital Medical University Affiliated Anzhen Hospital, Beijing, People’s Republic of China [*1]Center for Cardiac Intensive Care, Capital Medical University Affiliated Anzhen Hospital, Beijing, People’s Republic of China
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