Mortality Reduction With β‐Blockers in Ischemic Cardiomyopathy Patients Undergoing Coronary Artery Bypass Grafting

Lin, Terence; Hasaniya, Nahidh; Krider, Susan; Razzouk, Anees J.; Wang, Nan; Chiong, Jun R.

doi:10.1111/j.1751-7133.2010.00146.x

Cited by 18 publications

(7 citation statements)

References 39 publications

(59 reference statements)

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“…Because of the great heterogeneity of the studies, the random-effects model and sensitivity analyses approach were selected and 3 studies (Terence Lin (7), William E. Boden (8) and Michelle M (14)) were excluded. Also, the impact of removing each of the studies was evaluated in the summary results but the results did not change.…”

Section: Resultsmentioning

confidence: 99%

Comparing the effectiveness of revascularization interventions with medical therapy in patients with ischemic cardiomyopathy: A systematic review and meta-analysis

Faradonbeh

Azar

Rezapour

et al. 2018

Med. J. Islam. Repub. Iran

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Background: Determining the effectiveness of cardiovascular interventions plays an important role in reimbursement decisions, health care pricing, and providing clinical guidance on the use of existing clinical technologies. This study aimed to review and analyze the effectiveness of revascularization interventions (CABG and PCI) compared to medical therapy in patients with ischemic cardiomyopathy. Methods: Different databases were searched up to December 2017. The articles were selected based on inclusion and exclusion criteria. Quality of all studies was evaluated by Jadad score and relevant checklists. The I2 test was used to test heterogeneity. Also, to integrate the results of similar studies, meta-analysis was done using STATA software. Results: A total of 18 studies were included. Based on the random effects model, the overall results of comparing the effectiveness of revascularization interventions with medical therapy were as follow: 38.94 [95% CI: 26.95-50.94, p<0.001, I 2 = 99.6%, p<0.001], [75.31, 95% CI: 74.06-76.57, p<0.001, I 2 = 88.8, p<0.001], and 75.76 [95% CI: 71.99-79.53, p<0.001, I2= 99.2, p<0.001] for cardiac mortality rate, quality of life, and 5-year survival, respectively. Also, in patient satisfaction index, revascularization interventions were shown to be more effective than medical therapy. Conclusion: This study showed that revascularization interventions in all studied indices were more effective than medical therapy. Also, between revascularization interventions, PCI was more effective in cardiovascular mortality and 5-year survival than CABG in terms of quality of life. Moreover, CABG was more effective than PCI. In patient satisfaction index, the results of the 2 included studies were contradictory.

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Section: Resultsmentioning

confidence: 99%

Comparing the effectiveness of revascularization interventions with medical therapy in patients with ischemic cardiomyopathy: A systematic review and meta-analysis

Faradonbeh

Azar

Rezapour

et al. 2018

Med. J. Islam. Repub. Iran

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“…In addition to a preoperative beta-blockade in patients with reduced LVEF, continuing beta-blockers during the early postoperative phase has also been shown to significantly reduce the 30day mortality rate following CABG [170]. Strong evidence suggests that beta-blockers reduce the number of deaths in patients with a recent MI or reduced LVEF (<35%) [171,172].…”

Section: Postoperative Beta-blockersmentioning

confidence: 99%

2017 EACTS Guidelines on perioperative medication in adult cardiac surgery

Sousa-Uva¹,

Head²,

Milojevic³

et al. 2017

European Journal of Cardio-Thoracic Surgery

323

224

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Disclaimer 2017: The EACTS Guidelines represent the views of the EACTS and were produced after careful consideration of the scientific and medical knowledge and the evidence available at the time of their dating. The EACTS is not responsible in the event of any contradiction, discrepancy and/or ambiguity between these Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the EACTS Guidelines fully into account when exercising their clinical judgment, as well as in the determination and the implementation of preventive, diagnostic or therapeutic medical strategies; however, the EACTS Guidelines do not in any way whatsoever override the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient's health condition and, where appropriate and/or necessary, in consultation with that patient and the patient's care provider. Nor do EACTS Guidelines exempt health professionals from giving full and careful consideration to the relevant official, updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient's case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional's responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription.

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“…Evidence for ACEi has been discussed previously and little data exists for β-blockers. In 2010, Lin et al 72 reported improvements in mortality both in-hospital and at 30 days in 1369 post-CABG patients with EF < 40%. However, Ferguson et al (2002) 63 reported a trend toward increased 30-day mortality in patients with EF < 30%.…”

Section: Patients With LV Dysfunctionmentioning

confidence: 99%

Secondary Prevention Medications Post Coronary Artery Bypass Grafting Surgery—A Literature Review

Dimitriadis

Qian

Irvine

et al. 2021

J Cardiovasc Pharmacol Ther

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Secondary prevention after coronary artery bypass graft (CABG) surgery is imperative in slowing the progression of atherosclerosis in both native and grafted vessels. Aspirin and statins remain the key medications for all patients without significant contraindications. The evidence for dual antiplatelet therapy with clopidogrel is less convincing, but there is hope for newer antiplatelet agents, such as ticagrelor. Meanwhile, β-blockers and angiotensin converting enzyme inhibitors might only offer benefits to specific sub-groups. Post-CABG patients appear to have different medication needs to the general cardiovascular patient and respond differently. In this review, we cover the drug regimens proposed by recent guidelines and the evidence behind their use. Assessing the evidence behind these recommendations, we find that there is an unmet need in some areas for robust population-specific evidence. We hope that future research will address this gap.

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Mortality Reduction With β‐Blockers in Ischemic Cardiomyopathy Patients Undergoing Coronary Artery Bypass Grafting

Cited by 18 publications

References 39 publications

Comparing the effectiveness of revascularization interventions with medical therapy in patients with ischemic cardiomyopathy: A systematic review and meta-analysis

Comparing the effectiveness of revascularization interventions with medical therapy in patients with ischemic cardiomyopathy: A systematic review and meta-analysis

2017 EACTS Guidelines on perioperative medication in adult cardiac surgery

Secondary Prevention Medications Post Coronary Artery Bypass Grafting Surgery—A Literature Review

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