Why the study?
Does the presence of coronary artery disease increase postoperative mortality in surgical patients?
Does the presence of coronary artery disease increase postoperative mortality in surgical patients?
Patients with coronary artery disease undergoing surgery face a high postoperative mortality rate, particularly those with a recent preoperative myocardial infarction.
CAD doubles early postoperative mortality; observational data leaves open whether preoperative optimization modifies risk.
A two-month postoperative follow-up of 1,005 patients with coronary artery disease demonstrated that 225 patients, or 22.3%, died. This mortality was twice that of surgical patients in similar circumstances but without specific diagnosis of coronary artery disease. Among 27 patients who had suffered a preoperative myocardial infarction, less than three months before surgery, 11 died; this mortality of 40% was higher than the overall rate. The type of infarction was found to be significant, with a much lower mortality following subendocardial lesions as compared to transmural infarctions. Postoperative myocardial infarction was observed in 55 cases and resulted in 38 deaths, a mortality of 69%. Comparison of the various agents and methods used for anesthesia failed to show a significant difference.
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Arkins et al. (1964) studied this question.
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