Intraoperative hypotension with a systolic blood pressure reduction of 41-50 mm Hg from baseline was associated with increased odds of perioperative myocardial infarction (OR 3.42; 95% CI 1.13-10.3).
Case-Control (n=652)
Yes
Does intraoperative hypotension increase the risk of perioperative myocardial infarction in adults undergoing noncardiac surgery?
Intraoperative hypotension, especially a decrease in SBP >50 mm Hg from baseline, is strongly associated with an increased risk of perioperative myocardial infarction in patients undergoing noncardiac surgery.
Effect estimate: OR 3.42 (95% CI 1.13-10.3)
BACKGROUND: Hemodynamic instability during anesthesia and surgery is common and associated with cardiac morbidity and mortality. Information is needed regarding optimal blood pressure (BP) threshold in the perioperative period. Therefore, the effect of intraoperative hypotension (IOH) on risk of perioperative myocardial infarction (MI) was explored. METHODS: A nested case-control study with patients developing MI 50 mm Hg with considerably increased odds in respect to MI risk, OR = 22.6, (95% CI, 7.69-66.2). In patients with a very high-risk burden, the absolute risk of an MI diagnosis increased from 3.6 to 68 per 1000 surgeries. CONCLUSIONS: In patients undergoing noncardiac surgery, IOH is a possible contributor to clinically significant perioperative MI. The high absolute MI risk associated with IOH, among a growing population of patients with a high-risk burden, suggests that increased vigilance of BP control in these patients may be beneficial.
Hallqvist et al. (Fri,) conducted a case-control in High-risk patients undergoing noncardiac surgery (n=652). Intraoperative hypotension vs. No intraoperative hypotension or lesser decrease was evaluated on Acute myocardial infarction within 30 days (OR 3.42, 95% CI 1.13-10.3). Intraoperative hypotension with a systolic blood pressure reduction of 41-50 mm Hg from baseline was associated with increased odds of perioperative myocardial infarction (OR 3.42; 95% CI 1.13-10.3).