Abstract
In the current issue, Brinkman and colleagues1 use the Society of Thoracic SurgeonsNationalDatabase (STS-ND) to study the effect of preoperative β-blockade on postoperative coronary artery bypass grafting (CABG) outcomes. Their results show no mortality advantage and a paradoxically increased incidence of atrial fibrillation (AF) in patients receiving preoperative β-blockers, findings that challenge the continuation of this practice and its use as a quality metric. I will examine the rationale for preoperative β-blockade, controversies regarding its use innoncardiac surgery, the valueof β-blockade in CABG, and reasonable clinical recommendations based on the preponderance of current evidence.
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