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Beta-blockers increase MI risk after non-cardiac surgery

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Giving beta-blockers to patients undergoing non-cardiac surgery appears to increase their risk of myocardial infarction or death over the next month, a new study finds.

The paper is at odds with previous research which suggests that beta-blockers have a protective role against cardiac events post-surgery.

Researchers compared 238 patients who received the drug before or during surgery against 408 patients undergoing similar procedures without beta-blockers at the same hospital in Houston, Texas.

The beta-blocker group were more likely to die of any cause, or to have a non-fatal myocardial infarction or a cardiovascular event within 30 days of surgery. This disparity did not exist a year after the operation.

None of the patients who died were at high cardiac risk, but patients on beta-blockers who died had higher heart rates before surgery than those who did not.

The authors suggest that any protective role for the drug may only occur if the patient has a low heart rate before surgery.

Archives of Surgery (2008) 143: 940-944

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