Perioperative beta-blocker withdrawal and mortality in vascular surgical patients

Am Heart J. 2001 Jan;141(1):148-53. doi: 10.1067/mhj.2001.111547.


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.

MeSH terms

  • Adrenergic beta-Antagonists / adverse effects*
  • Aged
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / mortality*
  • Humans
  • Postoperative Period
  • Preoperative Care
  • Risk Factors
  • Substance Withdrawal Syndrome*
  • Vascular Surgical Procedures / adverse effects*


  • Adrenergic beta-Antagonists