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An Alternative View of Current Evidence in Support of Perioperative -Blockers
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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We read with interest the studies by Siddiqui et al1 and Lindenauer et al.2 Each report has, as its raison dêtre, the supposition that perioperative -blockade is the standard of care for the prevention of postoperative cardiac complications. Furthermore, both studies presume that physicians who do not prescribe -blockers are not practicing good perioperative medicine. We wish to express the contrarian view that the evidence supporting the recommendation for perioperative -blockade is insufficient and that a vast amount of research is still required in the field of perioperative risk reduction.
Two meta-analyses have pooled the data from randomized controlled studies of perioperative -blockade.3-4 Although both groups of reviewers found statistically significant reductions in myocardial infarction (MI), the pooled effect estimates were heavily weighted by 2 studies. One study was an interim analysis of an unblinded trial of highly selected, high-risk vascular patients.5 In the second study,6 the in-hospital incidence of . . . [Full Text of this Article] AUTHOR INFORMATION
W. Scott Beattie, MD, PhD, FRCPC;
Duminda N. Wijeysundera, MD;
Peter T. Choi, MD, MSc(Epid), FRCPC
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