What is the efficacy of beta-blocker use in CABG patients after hospital discharge?
The efficacy of beta-blocker use in CABG patients after hospital discharge is uncertain, as data from 2 RCTs and 1 large detailed observational analysis suggest that they exert no benefit over 2 years postoperatively.621 623 In contrast, some observational analyses have reported that they are, in fact, efficacious in high-risk subgroups (eg, those with perioperative myocardial ischemia or elderly subjects with heart failure).624 A contemporary analysis of prescription data from 3,102 Canadian patients, 83% of whom were prescribed a beta blocker at the time of discharge, reported that those receiving beta blockers had a reduced mortality rate during a mean follow-up of 75 months.625 Of note, improved survival was noted in all patient subgroups receiving beta blockers, even including those without perioper- ative myocardial ischemia or heart failure.