Perioperative Myocardial Infarction in Patients Undergoing Noncardiac Surgery

Abstract

Letters4 October 2011Perioperative Myocardial Infarction in Patients Undergoing Noncardiac SurgeryP.J. Devereaux, MD, PhD, Gordon Guyatt, MD, MSc, and Salim Yusuf, MBBS, DPhilP.J. Devereaux, MD, PhDFrom Hamilton General Hospital, Hamilton, Ontario L8L 2X2, Canada; McMaster University, Hamilton, Ontario L8N 3Z5, Canada; and Hamilton General Hospital, Hamilton, Ontario L8L 2X2, Canada.Search for more papers by this author, Gordon Guyatt, MD, MScFrom Hamilton General Hospital, Hamilton, Ontario L8L 2X2, Canada; McMaster University, Hamilton, Ontario L8N 3Z5, Canada; and Hamilton General Hospital, Hamilton, Ontario L8L 2X2, Canada.Search for more papers by this author, and Salim Yusuf, MBBS, DPhilFrom Hamilton General Hospital, Hamilton, Ontario L8L 2X2, Canada; McMaster University, Hamilton, Ontario L8N 3Z5, Canada; and Hamilton General Hospital, Hamilton, Ontario L8L 2X2, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-7-201110040-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Potyk states that we did not comment on the effects of perioperative β-blockade. On the basis of all the β-blocker trials in patients undergoing noncardiac surgery, there is strong evidence that β-blockade prevents perioperative MI. Contrary to Dr. Potyk's statement, perioperative β-blockade probably increases the risk for death and almost certainly increases the risk for stroke (1, 2). Our interpretation of these data is that controlling the sympathetic system in the perioperative setting is beneficial, but we need to find a way to do it safely and practically.Dr. Potyk believes that it is not necessary to ...