Perioperative beta-blocker withdrawal and mortality in vascular surgical patients.

Abstract:

OBJECTIVE:Our purpose was to determine the effect of postoperative beta-blocker withdrawal on mortality and cardiovascular events after vascular surgery. METHODS:Detailed data were collected on perioperative cardiovascular medication use and discontinuation and cardiovascular risk factors among consecutive major vascular surgical procedures at two university hospitals. RESULTS:A total of 140 patients received beta-blockers preoperatively. Mortality in the 8 patients who had beta-blockers discontinued postoperatively (50%) was significantly greater than in 132 patients who had beta-blockers continued (1.5%, odds ratio 65.0, P<.001). The effect of beta-blocker discontinuation was unaffected by adjustment by stratification for risk factors (all P< or =.01), for contraindications to restarting beta-blockers (P = .006), and by multivariable analyses adjusting for potential confounders (adjusted odds ratio 17.0, P =.01). beta-Blocker discontinuation also was associated with increased cardiovascular mortality (0% vs 29%, P =.005) and postoperative myocardial infarction (odds ratio 17.7, P =.003). CONCLUSION:Discontinuing beta-blockers immediately after vascular surgery may increase the risk of postoperative cardiovascular morbidity and mortality.

journal_name

Am Heart J

journal_title

American heart journal

authors

Shammash JB,Trost JC,Gold JM,Berlin JA,Golden MA,Kimmel SE

doi

10.1067/mhj.2001.111547

subject

Has Abstract

pub_date

2001-01-01 00:00:00

pages

148-53

issue

1

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(01)08062-0

journal_volume

141

pub_type

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