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Metoprolol at Surgery May Increase Risk

Posted on: Tuesday, 13 May 2008, 15:00 CDT

Beta-blocker drugs may help prevent heart attacks during surgery but they may increase the risk of death and major stroke, a Canadian study said.

The POISE Trial randomized 4,174 patients to receive extended-release metoprolol succinate and 4,177 patients to receive placebo starting two to four hours before surgery and continuing for 30 days after surgery, Dr. Salim Yusuf, POISE steering committee chairman, of McMaster University, in Hamilton, said.

A major accomplishment of POISE was that anesthesiologists, cardiologists, internists and surgeons at 190 centers in 23 countries came together and randomized 8,351 patients -- more than four times as many patients than all the previous perioperative beta-blocker trials combined, Yusuf said in a statement.

Fewer patients in the metoprolol group -- 176 -- than in the placebo group -- 239 -- suffered a heart attack, indicating that patients receiving metoprolol were 27 percent less likely to suffer a heart attack. However, the study, published online in the journal The Lancet, found 129 metoprolol patients compared to 97 placebo patients died, indicating that patients receiving metoprolol were 33 percent more likely to die.

Further, 41 metoprolol patients versus 19 placebo patients suffered a stroke, indicating that patients receiving metoprolol had more than double the risk of a stroke.

Source: United Press International

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