{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T13:16:05Z","timestamp":1780492565451,"version":"3.54.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,1,11]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Relevant clinical studies have been small and have not convincingly demonstrated whether the perioperative initiation of beta\u2010blockers should be considered in patients with diabetes mellitus undergoing noncardiac surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">In this nationwide propensity score\u2013matched study, we included patients with diabetes mellitus undergoing noncardiac surgery between 2000 and 2011 from Taiwan's National Health Insurance Research Database. Patients were classified as beta\u2010blocker and non\u2013beta\u2010blocker cohorts. We further stratified beta\u2010blocker users into cardioprotective beta\u2010blocker (atenolol, bisoprolol, metoprolol, or carvedilol) and other beta\u2010blocker users. To investigate time of initiation of beta\u2010blocker use, initiation time was stratified into 2 periods (&gt;30 and \u226430\u00a0days preoperatively). The outcomes of interest were in\u2010hospital and 30\u2010day mortality. After propensity score matching, we identified 50\u00a0952 beta\u2010blocker users and 50\u00a0952 matched controls. Compared with non\u2013beta\u2010blocker users, cardioprotective beta\u2010blocker users were associated with lower risks of in\u2010hospital (odds ratio 0.75, 95% CI 0.68\u20130.82) and 30\u2010day (odds ratio 0.75, 95% CI 0.70\u20130.81) mortality. Among initiation times, only the use of cardioprotective beta\u2010blockers for &gt;30\u00a0days was associated with decreased risk of in\u2010hospital (odds ratio 0.72, 95% CI 0.65\u20130.78) and 30\u2010day (odds ratio 0.72, 95% CI 0.66\u20130.78) mortality. Of note, use of other beta\u2010blockers for \u226430\u00a0days before surgery was associated with increased risk of both in\u2010hospital and 30\u2010day mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The use of cardioprotective beta\u2010blockers for &gt;30\u00a0days before surgery was associated with reduced mortality\u00a0risk,\u00a0whereas short\u2010term use of beta\u2010blockers was not associated with differences in mortality in patients with diabetes mellitus.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.116.004392","type":"journal-article","created":{"date-parts":[[2017,1,11]],"date-time":"2017-01-11T02:30:28Z","timestamp":1484101828000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Impact of Beta\u2010Blocker Initiation Timing on Mortality Risk in Patients With Diabetes Mellitus Undergoing Noncardiac Surgery: A Nationwide Population\u2010Based Cohort Study"],"prefix":"10.1161","volume":"6","author":[{"given":"Ray\u2010Jade","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan"},{"name":"Division of General Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsi","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Chest, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lung\u2010Wen","family":"Tsai","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan"},{"name":"Department of Medical Education, Taipei Medical University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000106"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000000150"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1979.03290450033020"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.12.2901"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.161.2.242"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.720847"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.7.1588"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199612053352301"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.332.7556.1482"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31820fca0b"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.05.056"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2013.10.011"},{"key":"e_1_3_5_14_2","first-page":"157","article-title":"Accuracy of diabetes diagnosis in health insurance claims data in Taiwan","volume":"104","author":"Lin CC","year":"2005","unstructured":"Lin CC, Lai MS, Syu CY, Chang SC, Tseng FY. 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