KEY FINDINGS
-
Metoprolol reduced the risk of myocardial infarction but increased the risk of death and stroke. The negative outcomes appeared to occur through an increase in hypotension on surgical floors.
-
The POISE trial highlighted the risk in assuming a perioperative beta-blocker regimen has benefit without substantial harm, and the importance and need for large randomized trials in the perioperative setting.
-
Patients are unlikely to accept the risks associated with perioperative extended-release metoprolol.