Perioperative β-blocker withdrawal and mortality in vascular surgical patients

Jonathan B. Shammash, Jeffrey C. Trost, Julie M. Gold, Jesse A. Berlin, Michael A. Golden, Stephen E. Kimmel

Research output: Contribution to journalArticle

Abstract

Objective: Our purpose was to determine the effect of postoperative β-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 β-blockers preoperatively. Mortality in the 8 patients who had β-blockers discontinued postoperatively (50%) was significantly greater than in 132 patients who had β-blockers continued (1.5%, odds ratio 65.0, P < .001). The effect of β-blocker discontinuation was unaffected by adjustment by stratification for risk factors (all P ≤ .01), for contraindications to restarting β-blockers (P = .006), and by multivariable analyses adjusting for potential confounders (adjusted odds ratio 17.0, P = .01). β-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 β-blockers immediately after vascular surgery may increase the risk of postoperative cardiovascular morbidity and mortality.

Original languageEnglish (US)
Pages (from-to)148-153
Number of pages6
JournalAmerican heart journal
Volume141
Issue number1
DOIs
StatePublished - Jan 1 2001

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Shammash, J. B., Trost, J. C., Gold, J. M., Berlin, J. A., Golden, M. A., & Kimmel, S. E. (2001). Perioperative β-blocker withdrawal and mortality in vascular surgical patients. American heart journal, 141(1), 148-153. https://doi.org/10.1067/mhj.2001.111547