Clonidine Reduces Risk of Surgery in Heart Patients

The findings were reported in the August 2004 issue of Anesthesiology.

This is the second drug that researchers have added to the list of inexpensive preventive measures available to heart patients before noncardiac surgery. The first drug was the beta blocker atenolol, which blocks stress hormones in the brain from stimulating the heart.

The clonidine study involved 190 male patients scheduled to undergo noncardiac surgery who had been diagnosed with coronary artery disease or had at least two of five risk factors for cardiac disease: age 60 or over, hypertension, smoking within a year, cholesterol of 240 or greater, and diabetes. The surgeries performed included orthopedic, head and neck, abdominal, and others. A total of 125 patients received a 0.2 mg oral table of clonidine the night before surgery, a transdermal patch of clonidine the night before surgery, and a 0.2 mg tablet one hour before surgery. A control group received only placebos. The followup after four years showed a death rate of 15% in the clonidine group vs 29% in the placebo group.

The researchers concluded that patients with or at risk for coronary artery disease who undergo noncardiac surgery should be given either atenolol or clonidine before surgery. "Drug therapy to prevent blocked arteries prevents the start of a chain of events leading to heart attack and death,” said lead researcher Arthur Wallace, M.D., Ph.D., associate professor of anesthesia and perioperative care, University of California, San Francisco (USA).




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