Reinfarction Following Anesthesia in Patients with Myocardial Infarction

Rao, Tadikonda L. K.; Jacobs, Kurt H.; El-Etr, Adel A.

doi:10.1097/00000542-198312000-00003

Cited by 576 publications

(122 citation statements)

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“…One study of men with a history of CAD undergoing noncardiac surgery found a postoperative MI rate of 4.1 % [7]. A retrospective study of patients with a history of MI undergoing noncardiac surgery found reinfarction rates of 2.3 % for those whose surgery was three to six months after MI and 5.7 % for those whose surgery was less than three months after MI [14].…”

Section: Discussionmentioning

confidence: 99%

Impact of preoperative myocardial infarction on surgical outcomes in inpatient orthopaedic surgery

Lim

Edelstein

Jain

et al. 2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to evaluate the impact of a preoperative myocardial infarction (MI) on outcomes of inpatient orthopaedic operations. Methods The National Surgical Quality Improvement Program database was used to identify patients who underwent common orthopaedic operations from 2006 to 2010. Patient demographic data, comorbidities, complications, and lengths of stay were collected. Multivariate logistic regression and linear regression models were used to compare outcomes for patients with and without a history of MI in the six months prior to surgery. Results Of the 32,462 patients identified, 86 had sustained an MI in the six months prior to surgery. The MI cohort had no cardiac complications but had increased incidences of superficial surgical site infection, unplanned re-intubation, ventilator-assisted respiration for more than 48 hours, pneumonia, sepsis or septic shock, and postoperative mortality within 30 days of surgery, as well as prolonged lengths of stay. Following logistic regression to adjust for baseline differences, a history of MI showed no association with cardiac complications and was significantly associated with superficial surgical site infection (OR 3.6, 95 % CI 1.1-11.8), ventilator dependence for over 48 hours (OR 4.0, 95 % CI 1.1-14.0), and extended length of stay (median with interquartile range 4 [4-4] vs. 5 days).Conclusions A myocardial infarction within six months prior to orthopaedic surgery is not associated with a higher risk of 30-day perioperative cardiac complications; however, it is associated with increased rates of surgical site infection, prolonged ventilator dependence, and longer hospital stay.

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Section: Discussionmentioning

confidence: 99%

Impact of preoperative myocardial infarction on surgical outcomes in inpatient orthopaedic surgery

Lim

Edelstein

Jain

et al. 2013

International Orthopaedics (SICOT)

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“…More recent data suggest that careful patient selection, optimal preoperative assessment, invasive haemodynamic monitoring and cardiovascular pharmacological support may be associated with a dramatic reduction in re-infarction rates and cardiac deaths. Rao et al 46 reported re-infarction rates of 5.8 per cent and 2.3 per cent within 0-3 months and 3-6 months respectively following infarction. The risk of perioperatire cardiac death is increased tenfold in patients aged over 70 years while all cardiac complications are more likely with major intra-abdominal, intra-thoracic and aortic vascular procedures.…”

Section: Multivariate Risk Factor Analysismentioning

confidence: 98%

Anaesthesia for abdominal aortic surgery — a review (Part I)

Cunningham

1989

Can J Anaesth

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“…Perioperative MI mainly occurs either at the end of the surgical procedure or 24-96 h after non-cardiac surgery [36][37][38] . Although the mechanism underlying perioperative MI is unknown, it was assumed to resemble that of nonsurgical MI 39 , that is, acute plaque rupture and coronary thrombosis 40,41 .…”

Section: Pathophysiology Of Perioperative Myocardial Infarctionmentioning

confidence: 99%

Perioperative myocardial infarction in non-cardiac surgery. Pathophysiology and clinical implications

2006

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Advances in surgical and anaesthetic techniques and an aging patient population have resulted in more complex procedures being performed in greater numbers of aged subjects and in patients with a high likelihood of significant cardiovascular disease. Nearly one fourth of non-cardiac surgical procedures (major intra-abdominal, thoracic, vascular, and orthopaedic procedures) performed in persons older than 65 years have been found to be associated with significant perioperative cardiovascular morbidity and mortality. During previous years the main attempt was to define strategies to accurately estimate perioperative cardiovascular risk based either on the characteristics of surgery and on patient characteristics. More recently preventive medical strategies have been proposed. Therefore, the physician has to be aware of the key elements useful to calculate the perioperative cardiovascular risk, and of the medical preventive treatment or further interventions to adopt in patients candidate to surgery.

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Reinfarction Following Anesthesia in Patients with Myocardial Infarction

Cited by 576 publications

References 0 publications

Impact of preoperative myocardial infarction on surgical outcomes in inpatient orthopaedic surgery

Impact of preoperative myocardial infarction on surgical outcomes in inpatient orthopaedic surgery

Anaesthesia for abdominal aortic surgery — a review (Part I)

Perioperative myocardial infarction in non-cardiac surgery. Pathophysiology and clinical implications

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