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Invited Critique
October 20, 2008

β-Blockade in Noncardiac Surgery—Invited Critique

Arch Surg. 2008;143(10):944. doi:10.1001/archsurg.143.10.944

The article by Kaafarani et al presents a retrospective report of patients operated on at a single institution in 2000. The objective was to determine the effect of β-blockers on perioperative heart rate and perioperative cardiac morbidity and mortality in all noncardiac surgery. The findings suggest that the β-blocker group experienced higher rates of myocardial infarction (2.94% vs 0.74%) and 30-day mortality (2.52% vs 0.25%) compared with the group not receiving β-blockers. The most supported and compelling finding demonstrates that within the β-blocker group those who died in the perioperative period had significantly higher preoperative heart rates than those without perioperative death.

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