Preoperative beta blockade is associated with increased rates of 30-day major adverse cardiac events in critical limb ischemia patients undergoing infrainguinal revascularization

Shannon, Alexander H.; Mehaffey, J. Hunter; Cullen, J. Michael; Hawkins, Robert B.; Roy, Rishi; Upchurch, Gilbert R.; Robinson, William P.

doi:10.1016/j.jvs.2018.07.077

Cited by 13 publications

(1 citation statement)

References 28 publications

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“…For example, it has been reported that baseline β1 blocker use was associated with lower 30-day and 10-year mortality in 3371 patients undergoing major vascular surgery [87]. However, it has also been reported that baseline β blocker use was associated with an increased cardiovascular event risk in 11,785 patients undergoing infrainguinal revascularization for critical limb ischemia [88] and in 14,671 patients with type 2 diabetes and established atherosclerotic cardiovascular disease [89]. Moreover, Cimaglia et al found that baseline β blocker use was not associated with an increased cardiovascular event risk in 618 diabetic patients with the most advanced stage of peripheral artery disease [90].…”

Section: Role Of β1 Adrenoceptors In Atherosclerosismentioning

confidence: 99%

Sympathetic Nervous System and Atherosclerosis

Wang,

Anesi,

Maier

et al. 2023

IJMS

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Atherosclerosis is characterized by the narrowing of the arterial lumen due to subendothelial lipid accumulation, with hypercholesterolemia being a major risk factor. Despite the recent advances in effective lipid-lowering therapies, atherosclerosis remains the leading cause of mortality globally, highlighting the need for additional therapeutic strategies. Accumulating evidence suggests that the sympathetic nervous system plays an important role in atherosclerosis. In this article, we reviewed the sympathetic innervation in the vasculature, norepinephrine synthesis and metabolism, sympathetic activity measurement, and common signaling pathways of sympathetic activation. The focus of this paper was to review the effectiveness of pharmacological antagonists or agonists of adrenoceptors (α1, α2, β1, β2, and β3) and renal denervation on atherosclerosis. All five types of adrenoceptors are present in arterial blood vessels. α1 blockers inhibit atherosclerosis but increase the risk of heart failure while α2 agonism may protect against atherosclerosis and newer generations of β blockers and β3 agonists are promising therapies against atherosclerosis; however, new randomized controlled trials are warranted to investigate the effectiveness of these therapies in atherosclerosis inhibition and cardiovascular risk reduction in the future. The role of renal denervation in atherosclerosis inhibition in humans is yet to be established.

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