Résumé :
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[BDSP. Notice produite par INIST vR0x7s79. Diffusion soumise à autorisation]. Context Patients who undergo major vascular surgery are at increased risk of perioperative cardiac complications. High-risk patients can be identified by clinical factors and noninvasive cardiac testing, such as dobutamine stress echocardiography (DSE) ; however, such noninvasive imaging techniques carry significant disadvantages. A recent study found that perioperative bêta-blocker therapy reduces complication rates in high-risk individuals. Objective To examine the relationship of clinical characteristics, DSE results, bêta-blocker therapy, and cardiac events in patients undergoing major vascular surgery. Design and Setting Cohort study conducted in 1996-1999 in the following 8 centers : Erasmus Medical Centre and Sint Clara Ziekenhuis, Rotterdam, Twee Steden Ziekenhuis, Tilburg, Academisch Ziekenhuis Utrecht, Utrecht, and Medisch Centrum Alkmaar, Alkmaar, the Netherlands ; Ziekenhuis Middelheim, Antwerp, Belgium ; and San Gerardo Hospital, Monza, Istituto di Ricovero e Cura a Carattere Scientifico, San Giovanni Rotondo, Italy. Patients A total of 1351 consecutive patients scheduled for major vascular surgery ; DSE was performed in 1097 patients (81%), and 360 (27%) received bêta-blocker therapy. Main Outcome Measure Cardiac death or nonfatal myocardial infarction within 30 days after surgery, compared by clinical characteristics, DSE results, and bêta-blocker use. Results Forty-five patients (3.3%) had perioperative cardiac death or nonfatal myocardial infarction. (...)
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