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Am Heart J. 2001 Jan;141(1):148-53.

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

Author information

1
Division of General Internal Medicine, Cornell Medical Associates, Weill Medical College of Cornell University, New York, NY, USA. jshammas@med.cornell.edu

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.

PMID:
11136500
DOI:
10.1067/mhj.2001.111547
[Indexed for MEDLINE]

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