Key result
Elective medium-to-low risk surgery was associated with a lower 3-year incidence of MI/ACS compared to controls (1.9% vs 2.0%, p<0.001) and lower overall mortality (20.2% vs 25.7%, p<0.001).
Why the study?
Does routine elective surgery increase the risk of subsequent myocardial infarction or acute coronary syndrome in asymptomatic patients aged 50-75 years with no prior heart disease?
Cohort (n=183,534)
Does routine elective surgery increase the risk of subsequent myocardial infarction or acute coronary syndrome in asymptomatic patients aged 50-75 years with no prior heart disease?
Routine elective surgery in asymptomatic patients without prior heart disease is associated with a lower risk of subsequent MI/ACS and improved overall survival, suggesting a potential health benefit from pre-operative assessment.
We speculated that asymptomatic patients undergoing routine surgery might be at higher risk of subsequent cardiac events. We studied 183,534 patients with no prior admission for heart disease, aged 50-75 years, admitted electively for one of five operations considered medium to low risk of peri-operative cardiac morbidity, between January 1997 and December 2005. Controls were generated from linked records. Within 3 years 3444 (1.9%) patients undergoing operations had subsequent myocardial infarction/acute coronary syndrome (MI/ACS) compared with 3708 (2.0%) controls (p < 0.001). Overall 8406 (4.6%) patients undergoing surgery had MI/ACS compared with 9306 (5.1%) controls (p < 0.001). Of patients undergoing surgery, 20.2% died compared with 25.7% of controls (p < 0.001). Patients undergoing certain surgical procedures did not have a higher incidence of readmission for cardiac events, but had a general survival benefit compared with other elective hospital admissions. Assessment for surgery may represent a health benefit beyond the original surgery.
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McFarlane et al. (2012) conducted a cohort in No prior admission for heart disease (n=183,534). Elective medium-to-low risk surgery vs. Controls from linked records was evaluated on Myocardial infarction/acute coronary syndrome (MI/ACS) within 3 years (p=< 0.001). Elective medium-to-low risk surgery was associated with a lower 3-year incidence of MI/ACS compared to controls (1.9% vs 2.0%, p<0.001) and lower overall mortality (20.2% vs 25.7%, p<0.001).
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