Perioperative cardiac adverse events [heart injuries caused by general anesthesia and
surgical procedures] are a significant public health issue, with more than 60,000 deaths per
annum in patients having surgery for non-heart related issues. There are virtually no
evidence-based medical strategies for effective prevention of these events. Preoperative drug
treatment with beta blockade drugs used for high blood pressure, perioperative therapy with
lipid lowering drugs such as statins, alpha-receptor agonists such as clonidine used for high
blood pressure, and aspirin have all been investigated as potential mitigating treatments,
but without positive clinical outcomes and, in some cases, creating more hemodynamic
instabilities that result in heart injury. In light of this, investigators propose to
evaluate the safety and efficacy of using increasing doses of beta blockade drugs immediately
after surgery and to assess the value of high-sensitivity cardiac troponin level testing of
the blood in predicting those patients who would benefit most from perioperative beta blocker
therapy.