whether a beta-blocker should be started before noncardiac surgery

January 2008

Experts are debating whether a beta-blocker should be started before noncardiac surgery.

Recent American Heart Assoc guidelines recommend starting beta-blockers before surgery in high-risk patients...to reduce the risk of heart attack and death.

But now "POISE," a large study using extended-release metoprolol (Toprol-XL), shows a LOWER risk of heart attack...but HIGHER risk of stroke and death. For every 1000 patients treated for 30 days, metoprolol prevents 15 heart attacks...but leads to eight deaths and five disabling strokes.

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