We investigated the effects of maintaining beta-blockers on the day of surgery on the incidence of atrial fibrillation and postoperative acute kidney injury (AKI) in patients undergoing cardiac surgery. We conducted a multicentre prospective observational study with propensity matching on patients treated with beta-blockers. We collected their baseline patient characteristics, comorbidities, and operative and postoperative outcomes. The endpoints were postoperative atrial fibrillation and AKI after cardiac surgery. Of the 1789 included patients, propensity matching led to 583 patients in each group. Maintenance of beta-blockers was not associated with a reduced risk of atrial fibrillation (odds ratio: 0.86 [95% confidence interval 0.66–1.14], =0.335; 141 patients [24.2%] 126 patients [21.6%]). Sensitivity analysis did not demonstrate association between beta-blocker maintenance and atrial fibrillation after cardiac surgery (odds ratio: 0.93 [95% confidence interval: 0.72–1.22], =0.625). Maintenance of beta-blockers was associated with a higher rate of norepinephrine use (415 [71.2%] 465 [79.8%], =0.0001) and postoperative AKI (124 [21.3%] 159 [27.3%], =0.0127). No statistically significant difference was observed in ICU length of stay. Maintenance of beta-blockers on the day of surgery was not associated with a reduced incidence of postoperative atrial fibrillation. However, maintenance of beta-blockers was associated with increased usage of vasopressors, potentially contributing to adverse postoperative renal events. NCT04769752.

中文翻译：

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β受体阻滞剂的维持和心脏手术相关的结果：前瞻性倾向匹配多中心分析


我们研究了手术当天维持β受体阻滞剂对接受心脏手术的患者心房颤动和术后急性肾损伤（AKI）发生率的影响。我们对接受β受体阻滞剂治疗的患者进行了一项多中心前瞻性观察研究，并进行了倾向匹配。我们收集了他们的基线患者特征、合并症以及手术和术后结果。终点是心脏手术后的术后心房颤动和 AKI。在 1789 名患者中，倾向匹配得出每组 583 名患者。维持β受体阻滞剂与心房颤动风险降低无关（比值比：0.86 [95% 置信区间 0.66–1.14]，=0.335；141 名患者 [24.2%] 126 名患者 [21.6%]）。敏感性分析并未证明β受体阻滞剂维持治疗与心脏手术后心房颤动之间存在关联（比值比：0.93 [95% 置信区间：0.72–1.22]，=0.625）。维持β受体阻滞剂与较高的去甲肾上腺素使用率（415 [71.2%] 465 [79.8%]，=0.0001）和术后 AKI（124 [21.3%] 159 [27.3%]，=0.0127）相关。 ICU 住院时间没有观察到统计学上的显着差异。手术当天维持β受体阻滞剂与术后心房颤动发生率降低无关。然而，维持β受体阻滞剂与升压药的使用增加有关，可能导致术后肾脏不良事件。 NCT04769752。