Washington: Physicians should desist from orderingstress tests and prescribing beta blockers to patients before non-cardiac surgeries, says a new study.

Since such pre-operative tests and medications do not save lives, they can be skipped safely, a study by physicians at the University of Michigan (U-M) said.

Stress tests do not reliably predict potentially fatal issues such as coronary artery clots and spasms, and beta blockers can harm patients whose heart disease is stable if dosages are not carefully monitored over months.

The study released new guidelines showing pre-operative medications should be reserved for only high risk patients undergoing complicated surgeries.

U-M researchers have gone a step further by critically evaluating other expensive pre-operative practices -- stress testing and coronary re-vascularizations, namely, stenting and bypass surgery for patients with stable heart disease.

Re-vascularization is a surgical procedure for the provision of a new, additional, or augmented blood supply to a body part or organ. These patients do not benefit from re-vascularization as studies show that it may trigger as many events as it prevents.
"Physicians may struggle with implementing these evidence-based guidelines for a variety of reasons," says senior study author Kim Eagle, Director of the U-M Cardiovascular Centre.

They include "legal concerns regarding pre-operative cardiac events, pressure from surgical colleagues and reliance on testing and procedures for income", adds Eagle.
Eagle and his U-M colleagues describe screening patients with stable cardiac disease, before non-cardiac surgeries such as hip replacement and gallbladder surgery as a failed strategy, says a UM release.

These findings are slated for publication in Annals of Internal Medicine.

-- IANS