B-blocker therapy in coronary artery bypass surgery : our experience at queen alia heart institute

الملخص EN

Objective: The objective of the study was to look at the effect of using ?-blockers perioperatively in patients undergoing coronary artery bypass graft surgery at Queen Alia Heart Institute.

Methods: This is a retrospective analysis of all patients who underwent coronary artery bypass graft surgery between April 2005 and September 2006 at Queen Alia Heart Institute.

The data collected included the patients' demographic characteristics, risk factors for coronary artery disease, history of myocardial infarction, renal dysfunction, history of prior cardiac surgery and the nature of coronary artery disease.

We assessed operative mortality, rate of stroke, atrial or ventricular arrhythmias, duration of ventilatory support and Intensive Care Unit stay.

Inclusion criteria were adult patients who were admitted for coronary artery bypass graft surgery, excluding patients who had valvular surgery, aneurysmectomy and off pump bypass surgery.

Results: We had a total of 916 patients.

Four hundred and ten patients were on ?-blockers while the rest were not.

The two groups did not differ in their characteristics.

The mean age was 60.0 ± 11 years, with 24% females.

The mean Intensive Care Unit stay was 1.8 ± 0.5 days for the ?-blockers group and 2.0 ± 0.6 days for the non-?-blockers group (P=0.001).

Patients who had ?-blockers had a rate of atrial or ventricular arrhythmias of 26% compared to 38% in the non-?-blockers group (P=0.001).

The mean post-operative hospital stay for patients who received ?-blockers was 7.2 ± 3 days compared to 8.4 ± 3.2 days in the non-?- blockers group (P<0.001).

In-hospital mortality was 4.2% in the ?-blockers group and 5.3% in the non-?- blockers group (P=NS).

Stroke was seen in 2.1% in the first group compared to 3.3% in the non-?-blockers group (P=NS).

Ventilatory support for more than 24 hours was seen in 7.1% compared to 6.9% in the non-?- blockers group (P=NS).

Intra-Aortic Balloon Pump support was used in 4.9% compared to 5.2% in the non-?- blockers group (P=NS).

Conclusion: Perioperative ?-blockers use is associated with significantly lower incidence of arrhythmias, shorter hospital stay and non-significant lower in-hospital mortality.

They had no effect on ventilatory support or the use of intra-aortic balloon pump support.