In a commentary appearing in this week's Journal of the American Medical Association, heart specialists at the University of Michigan Health System make a plea for clarity on the best approach for prescribing beta blockers before surgery.
It's not unusual for patients to suffer a cardiac event during surgery, and in theory, beta blockers will reduce the risk by slowing the heartbeat, reducing blood vessel constriction, lowering demand of the heart muscle for oxygen, and generally relieving stress on the heart. However, a one-size-fits-all approach for prescribing beta blockers can harm patients at low-risk for having a heart attack.
Future clinical studies using clear models of dose, duration and implementation could provide answers for doctors about the role of pre-surgery beta blockers, according to the U-M commentary.
Because of important design, treatment and analytical variations, previous clinical trials are hard to interpret.
For instance, the 2001 DECREASE I study included high-risk patients with known coronary blockages who faced high risk surgery. Importantly, the beta blockers were given based on individual heart rate and blood pressure. In contrast, the recent 2008's POISE study included a mixed group of patients undergoing major non-cardiac surgery and took a long-acting drug.
Given these important differences, the studies have not offered clear answers about who should get beta blockers, what the starting dose should be and how doses should be adjusted for patients.
"The time has come for clarity across perioperative beta blocker studies," the U-M authors write.
Authors: Vineet Chopra, M.D., a hospitalist at U-M Health System and clinical assistant professor of internal medicine at the U-M Medical School and Kim A. Eagle, M.D., director of the U-M Cardiovascular Center and the Albion Walter Hewlett Professor of Internal Medicine.
Reference: Journal of the American Medical Association, Vol. 303, No. 6, Feb. 10, 2010.
Funding: NoneResources: U-M Cardiovascular Center
Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung
Scientists reveal source of human heartbeat in 3-D
07.08.2017 | University of Manchester
Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.
As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...
Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.
Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...
For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.
While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...
An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.
The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...
A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.
Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...
16.08.2017 | Event News
04.08.2017 | Event News
26.07.2017 | Event News
18.08.2017 | Life Sciences
18.08.2017 | Physics and Astronomy
18.08.2017 | Materials Sciences