Effect perioperative ß-blockade with increasing patient age

Editor's Note

No difference was found in the effect of perioperative ß-blockade (metoprolol continuous release 200 mg for 30 days) versus placebo on postoperative outcomes between older and younger patients in this study (POISE [perioperative ischemia evaluation] trial).

In this analysis of 8,351 patients from 190 centers in 23 countries, the effect of perioperative metoprolol on the major study outcomes (ie, stroke, myocardial infarction, mortality) was similar in older and younger patients.

A decreased resting heart rate was found with increasing age, but the data do not support the use of perioperative ß-blockade in any age subgroup to achieve benefits and avoid harms.

Current recommendations against the use of ß-blockade in high-risk patients having noncardiac surgery apply across all age groups, the researchers conclude.