Bisoprolol reduces cardiac death and myocardial infarction in high-risk patients as long as 2 years after successful major vascular surgery

Don Poldermans, E. Boersma, J. J. Bax, I. R. Thomson, B. Paelinck, L. L M Van De Ven, M. G. Scheffer, G. Trocino, C. Vigna, H. F. Baars, H. Van Urk, J. R T C Roelandt

Research output: Contribution to journalArticle

Abstract

Aim: To assess the long-term cardioprotective effect of bisoprolol in a randomized high-risk population after successful major vascular surgery. High-risk patients were defined by the presence of one or more cardiac risk factor(s) and a dobutamine echocardiography test positive for ischaemia. Methods: 1351 patients were screened prior to surgery, 846 patients had one or more risk factor(s), and 173 of these patients also had ischaemia during dobutamine echocardiography. One hundred and twelve patients could be randomized for additional bisoprolol therapy or standard care. Eleven patients died in the peri-operative period (up to 1 month after surgery). Randomized patients continued bisoprolol or standard care after surgery. During follow-up of 101 survivors (median 22 months, range 11-30) cardiac death or myocardial infarction was noted. No patient was lost during follow-up. Results: The incidence of cardiac events during follow-up in the bisoprolol group was 12% vs 32% in the standard care group (P=0.025). Cardiac death occurred in 15 patients, nine patients in the standard care and in six in the bisoprolol group; myocardial infarction occurred in six patients, five in the standard care and one in the bisoprolol group. The odds ratio for cardiac death or myocardial infarction after surgery in high-risk patients with additional bisoprolol therapy was 0.30 (0.11-0.83). Conclusions: Bisoprolol significantly reduced long-term cardiac death and myocardial infarction in high-risk patients after successful major cardiac vascular surgery.

Original languageEnglish
Pages (from-to)1353-1358
Number of pages6
JournalEuropean Heart Journal
Volume22
Issue number15
DOIs
Publication statusPublished - 2001

Keywords

  • Beta-blockers
  • High-risk patients
  • Long-term follow-up
  • Major vascular surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Poldermans, D., Boersma, E., Bax, J. J., Thomson, I. R., Paelinck, B., Van De Ven, L. L. M., Scheffer, M. G., Trocino, G., Vigna, C., Baars, H. F., Van Urk, H., & Roelandt, J. R. T. C. (2001). Bisoprolol reduces cardiac death and myocardial infarction in high-risk patients as long as 2 years after successful major vascular surgery. European Heart Journal, 22(15), 1353-1358. https://doi.org/10.1053/euhj.2000.2555