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September 1, 1999Anesthesia & Analgesia

Adverse Cardiac Outcomes After Noncardiac Surgery in Patients with Prior Percutaneous Transluminal Coronary Angioplasty

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Why the study?

Does prior PTCA reduce adverse cardiac outcomes within 30 days after noncardiac surgery compared to nonrevascularized CAD or normal controls?

Population

Patients ≥45 years old undergoing noncardiac surgery from 1987 to 1993, including those with prior…

Comparison

Prior percutaneous transluminal coronary… vs Nonrevascularized coronary artery disease and…

Design

Cohort

Follow-up

30 days

Authors

KPKaren L. PosnerSprint (United States)GNGail A. Van NormanUniversity of WashingtonVCVictor ChanNuffield Orthopaedic Centre

Discussion

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Implication

May inform perioperative risk models incorporating PTCA history; extends observational data but leaves open causal benefit versus untreated CAD.

Structured PICO

Does prior PTCA reduce adverse cardiac outcomes within 30 days after noncardiac surgery compared to nonrevascularized CAD or normal controls?

P
Population
Patients ≥45 years old undergoing noncardiac surgery from 1987 to 1993, including those with prior percutaneous transluminal coronary angioplasty (PTCA), nonrevascularized coronary artery disease (CAD) (n=686), and normal controls (n=2155).
I
Intervention
Prior percutaneous transluminal coronary angioplasty (PTCA)
C
Comparator
Nonrevascularized coronary artery disease (CAD) and normal controls (no CAD)
O
Outcome
Composite of adverse cardiac outcomes (death, myocardial infarction, angina, congestive heart failure, malignant dysrhythmia, cardiogenic shock, coronary artery bypass graft, or PTCA) within 30 dayscomposite

Patients with prior PTCA have a lower risk of adverse cardiac outcomes after noncardiac surgery compared to those with untreated CAD, though their risk remains higher than healthy controls.

Limitations

  • Did not control for CAD severity
  • Did not control for medical management
  • Did not control for comorbidities
  • Small sample size for recent PTCA subgroup

Cite This Study

Posner et al. (1999) studied this question.

synapsesocial.com/papers/6a736b219d7f0771de5665aahttps://doi.org/10.1097/00000539-199909000-00003
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Operative Procedures Not Involving the Heart After Percutaneous Transluminal Coronary Angioplasty1992 · 78 citations
  2. 2The Incidence of Perioperative Myocardial Infarction in Men Undergoing Noncardiac Surgery1993 · 356 citations
  3. 3Reevaluation of Perioperative Myocardial Infarction in Patients With Prior Myocardial Infarction Undergoing Noncardiac Operations1990 · 105 citations
  4. 4Does Routine Stress-Thallium Cardiac Scanning Reduce Postoperative Cardiac Complications?1994 · 35 citations
  5. 5Percutaneous Transluminal Coronary Angioplasty1994 · 449 citations