ABSTRACT
Morbidity and mortality preoperatively mostly caused by cardiovascular events, which the myocardic ischemia form major part of it. This study was carried to assess the protective role of beta-blockers on the heart; by reducing the incidence of mortality and morbidity due to cardiovascular events during major vascular surgery over 6 months follow up post - operatively. High risk patients assigned by clinical finding and positive dobutamine stress echocardiography of 350 patients were. Divided in to two groups, group [1] received standard perioperative care; group [2] received standard care plus atenolol. A total of 350 patients in this study who they have positive clinical finding and positive dobutamine echocardighraphy. 118 patients randomized to receive atenolol, 106 patient to receive standard care, 106 patients excluded because they have been on other beta- blockers, and 20 patients excluded because they have extensive cardiac wall-motion akenisia during rest on stress test. Four patients died of cardiac [3.4%] in atenolol group in comparison to 18 patients [17%] died in the standard group [p<0.02]. Morbidity of nonfatal myocardial infarction in atenolol is [0%] compared with 18 patients [17%] in the standard group [P<0.01]. Atenolol has a significant role in reducing mortality and morbidity in coronary artery disease patients perioperatively especially in high risk patients