Maintenance of beta-blockers and cardiac surgery-related outcomes: a prospective propensity-matched multicentre analysis.

Autor:	Guinot PG; Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France; University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France. Electronic address: guinotpierregregoire@gmail.com., Fischer MO; Clinique Saint Augustin, Bordeaux Cedex, France., Nguyen M; Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France; University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France., Berthoud V; Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France., Decros JB; Department of Anaesthesiology and Critical Care Medicine, Caen University Medical Centre, Caen, France., Besch G; Department of Anaesthesiology and Critical Care Medicine, Besançon University Medical Centre, Besançon, France., Bouhemad B; Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France; University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France.
Jazyk:	angličtina
Zdroj:	British journal of anaesthesia [Br J Anaesth] 2024 Aug; Vol. 133 (2), pp. 288-295. Date of Electronic Publication: 2024 May 23.
DOI:	10.1016/j.bja.2024.04.018
Abstrakt:	Background: We investigated the effects of maintaining beta-blockers on the day of surgery on the incidence of atrial fibrillation and postoperative acute kidney injury (AKI) in patients undergoing cardiac surgery. Methods: We conducted a multicentre prospective observational study with propensity matching on patients treated with beta-blockers. We collected their baseline patient characteristics, comorbidities, and operative and postoperative outcomes. The endpoints were postoperative atrial fibrillation and AKI after cardiac surgery. Results: Of the 1789 included patients, propensity matching led to 583 patients in each group. Maintenance of beta-blockers was not associated with a reduced risk of atrial fibrillation (odds ratio: 0.86 [95% confidence interval 0.66-1.14], P=0.335; 141 patients [24.2%] vs 126 patients [21.6%]). Sensitivity analysis did not demonstrate association between beta-blocker maintenance and atrial fibrillation after cardiac surgery (odds ratio: 0.93 [95% confidence interval: 0.72-1.22], P=0.625). Maintenance of beta-blockers was associated with a higher rate of norepinephrine use (415 [71.2%] vs 465 [79.8%], P=0.0001) and postoperative AKI (124 [21.3%] vs 159 [27.3%], P=0.0127). No statistically significant difference was observed in ICU length of stay. Conclusions: Maintenance of beta-blockers on the day of surgery was not associated with a reduced incidence of postoperative atrial fibrillation. However, maintenance of beta-blockers was associated with increased usage of vasopressors, potentially contributing to adverse postoperative renal events. Clinical Trial Registration: NCT04769752. (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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