Grant: Operating Grant

Five hundred thousand adults in Canada, and 2 hundred million worldwide, have major surgery every year. Several million of these patients will have a major heart problem (example, a heart attack or death) after their surgery. We recently finished the worlds largest randomized trial testing the usefulness of a commonly used drug (called a beta-blocker) in patients having surgery. This study showed that the beta-blocker prevented heart attacks but increased the risk of stroke and death after surgery. These negative effects of beta-blockers after surgery were not known prior to our study. Our unexpected findings indicate why we need large studies of patients having surgery, to ensure that we are providing helpful and safe drugs. There is promising evidence that aspirin and clonidine (a drug that lowers a patients heart rate) may help prevent deaths and heart attacks around the time of surgery. Our proposed study will determine if these drugs can prevent deaths and heart attacks around the time of surgery. We will randomly assign patients to receive aspirin or placebo, and clonidine or placebo starting 2 to 4 hours before surgery. Patients will continue to take their study drugs for up to 30 days after surgery. We will follow all patients for 30 days and 1 year and note any heart attacks, deaths, strokes, or bleeding. This research will improve the treatment of patients having surgery and has the potential to save substantial health care costs.