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BMJ 2006;332 (24 June), doi:10.1136/bmj.332.7556.0-a
blockade may not benefit patients with diabetes
Perioperative
blockade in patients with diabetes undergoing major non-cardiac surgery may not significantly affect long term mortality and cardiac morbidity. The DIPOM Trial Group (p 1482) randomised 921 diabetic patients aged > 39 years and scheduled for major non-cardiac surgery to either 100 mg metoprolol or placebo, given from the day before surgery and continued for up to eight days. During a median follow-up of 18 months, all cause mortality, acute myocardial infarction, unstable angina, or congestive heart failure occurred in 21% of the metoprolol group and 20% of the placebo group. Confidence intervals, however, were wide, and the issue needs reassessment, conclude the authors.
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blockade in patients with diabetes undergoing major non-cardiac surgery: randomised placebo controlled, blinded multicentre trial