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J Cardiothorac Vasc Anesth. 2014 Jun;28(3):595-600. doi: 10.1053/j.jvca.2013.06.009. Epub 2013 Oct 16.

The effect of preoperative β-blocker use and race on long-term survival after coronary artery bypass grafting.

Author information

  • 1Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina. Electronic address: woneal@wakehealth.edu.
  • 2East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, North Carolina; Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
  • 3Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
  • 4East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
  • 5Department of General Surgery, University of Virginia School of Medicine, Charlottesville, Virginia.
  • 6Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Abstract

OBJECTIVE:

To date, racial differences in the long-term survival of coronary artery bypass grafting (CABG) patients who receive preoperative β-blockers have not been specifically examined. The purpose of this study was to examine the effect of preoperative β-blockers on long-term survival among black CABG patients and to compare the magnitude of this effect with white patients.

DESIGN:

A retrospective cohort study.

SETTING:

A tertiary referral heart hospital.

PARTICIPANTS:

13,354 patients undergoing CABG between 1992 and 2011.

MEASUREMENTS AND MAIN RESULTS:

Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model. A total of 1,448 (62%) black and 6,094 (55%) white patients had a history of preoperative β-blocker use. Among black patients, those receiving β-blockers survived longer than those not receiving β-blockers (adjusted HR = 0.77, 95% CI = 0.67-0.88). The survival advantage was comparable to that observed among white patients (adjusted HR = 0.88, 95% CI = 0.82-0.93).

CONCLUSION:

Black CABG patients benefited from preoperative β-blockers and the magnitude of the effect was comparable to that among white patients.

Copyright © 2014 Elsevier Inc. All rights reserved.

KEYWORDS:

CABG; long-term; mortality; survival; β-blockers

PMID:
24139457
[PubMed - indexed for MEDLINE]
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