- Journal
- BRITISH JOURNAL OF ANAESTHESIA
- Année
- 2024
- Volume
- 133
- Numéro
- 2
- Pages
- 288-295
- Mois
- AUG
- DOI
- 10.1016/j.bja.2024.04.018
Abstract
Background: We investigated the effects of maintaining beta-blockers on the day of surgery on the incidence of atrial fibrillation and postoperative acute kidney injury (AKI) in patients undergoing cardiac surgery. Methods: We conducted a multicentre prospective observational study with propensity matching on patients treated with beta-blockers. We collected their baseline patient characteristics, comorbidities, and operative and postoperative outcomes. The endpoints were postoperative atrial fibrillation and AKI after cardiac surgery. Results: Of the 1789 included patients, propensity matching led to 583 patients in each group. Maintenance of betablockers was not associated with a reduced risk of atrial fibrillation (odds ratio: 0.86 [95% confidence interval 0.66- 1.14], P = 0.335; 141 patients [24.2%] vs 126 patients [21.6%]). Sensitivity analysis did not demonstrate association between beta-blocker maintenance and atrial fibrillation after cardiac surgery (odds ratio: 0.93 [95% confidence interval: 0.72- 1.22], P = 0.625). Maintenance of beta-blockers was associated with a higher rate of norepinephrine use (415 [71.2%] vs 465 [79.8%], P = 0.0001) and postoperative AKI (124 [21.3%] vs 159 [27.3%], P = 0.0127). No statistically significant difference was observed in ICU length of stay. Conclusions: Maintenance of beta-blockers on the day of surgery was not associated with a reduced incidence of postoperative atrial fibrillation. However, maintenance of beta-blockers was associated with increased usage of vasopressors, potentially contributing to adverse postoperative renal events. Clinical trial registration: NCT04769752.