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Titolo:
Perioperative beta-blocker withdrawal and mortality in vascular surgical patients
Autore:
Shammash, JB; Trost, JC; Gold, JM; Berlin, JA; Golden, MA; Kimmel, SE;
Indirizzi:
Cornell Med Associates, Div Gen Internal Med, New York, NY USA Cornell MedAssociates New York NY USA en Internal Med, New York, NY USA Cornell Univ, Weill Med Coll, New York, NY 10021 USA Cornell Univ New York NY USA 10021 Weill Med Coll, New York, NY 10021 USA Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA USA Univ Penn Philadelphia PA USA Epidemiol & Biostat, Philadelphia, PA USA Univ Penn, Sch Med, Dept Biostat & Epidemiol, Philadelphia, PA USA Univ Penn Philadelphia PA USA Biostat & Epidemiol, Philadelphia, PA USA Univ Penn, Sch Med, Dept Surg, Div Vasc Surg, Philadelphia, PA USA Univ Penn Philadelphia PA USA Surg, Div Vasc Surg, Philadelphia, PA USA Univ Penn, Sch Med, Dept Med, Div Cardiovasc, Philadelphia, PA USA Univ Penn Philadelphia PA USA Med, Div Cardiovasc, Philadelphia, PA USA
Titolo Testata:
AMERICAN HEART JOURNAL
fascicolo: 1, volume: 141, anno: 2001,
pagine: 148 - 153
SICI:
0002-8703(200101)141:1<148:PBWAMI>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
HIGH-RISK PATIENTS; MYOCARDIAL-INFARCTION; NONCARDIAC SURGERY; ISCHEMIA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
16
Recensione:
Indirizzi per estratti:
Indirizzo: Shammash, JB New York Presbyterian Hosp, Cornell Med Ctr, Cornell InternalMed Assoc, 1484 1st Ave,2nd Floor, New York, NY 10021 USA New York Presbyterian Hosp 1484 1st Ave,2nd Floor New York NY USA 10021
Citazione:
J.B. Shammash et al., "Perioperative beta-blocker withdrawal and mortality in vascular surgical patients", AM HEART J, 141(1), 2001, pp. 148-153

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>-blockerdiscontinuation was unaffected by adjustment by stratification for risk factors (all P less than or equal to .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 surgerymay increase the risk of postoperative cardiovascular morbidity and mortality.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/10/20 alle ore 12:11:16