What question did this study set out to answer?

To identify clinical and perioperative variables associated with the occurrence of perioperative myocardial infarction following nonemergent vascular surgery.

August 1, 1995Archives of Surgery

Reducing Perioperative Myocardial Infarction Following Vascular Surgery

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Why the study?

Does perioperative beta-blocker use reduce perioperative myocardial infarction in patients undergoing major vascular surgery?

Population

159 patients undergoing nonemergent major vascular surgery

Comparison

Perioperative beta-blockers vs No perioperative beta-blockers

Design

Case-control

Follow-up

perioperative period

Authors

RYRichard A. YeagerOregon Health & Science University

Discussion

Member takes

Implication

May support beta-blocker consideration in vascular surgery; hypothesis-generating and requires randomized confirmation before practice change.

Key Points

To identify clinical and perioperative variables associated with the occurrence of perioperative myocardial infarction following nonemergent vascular surgery.
Conducted a case-control study screening 2,088 major vascular surgical procedures over a 4-year period using serial postoperative electrocardiography and cardiac enzyme tests.
Matched 53 patients with perioperative myocardial infarction to 106 non-infarction control patients by age, gender, operation type, hypertension, and coronary artery disease symptoms.
Assessed hemodynamic variables, operative duration, anesthetic choice, and cardiovascular medication exposure including beta-blockers, nitroglycerine, and ACE inhibitors.
Beta-blockers were administered to significantly fewer patients with perioperative myocardial infarction compared to matched controls (30% vs 50%, P = .01).
Overall perioperative beta-blockade was associated with a 50% reduction in perioperative myocardial infarction occurrence (P = .03).
No statistically significant associations were identified between perioperative myocardial infarction and operative duration, anesthetic type, blood pressure, or use of other cardiac medications.

Structured PICO

Does perioperative beta-blocker use reduce perioperative myocardial infarction in patients undergoing major vascular surgery?

Population

159 patients undergoing nonemergent major vascular surgery (53 cases with perioperative myocardial infarction matched with 106 controls without perioperative myocardial infarction)

Intervention

Perioperative beta-blockers

Comparator

No perioperative beta-blockers

Outcome

Occurrence of perioperative myocardial infarction (PMI)hard clinical

Perioperative beta-blockade is associated with a decreased incidence of perioperative myocardial infarction in patients undergoing major vascular surgery.

Cite This Study

Richard A. Yeager (1995) studied this question.

synapsesocial.com/papers/6a90ea237e3f32141373ca4b https://doi.org/10.1001/archsurg.1995.01430080071011

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Implication

May support beta-blocker consideration in vascular surgery; hypothesis-generating and requires randomized confirmation before practice change.

Reducing Perioperative Myocardial Infarction Following Vascular Surgery

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Reducing Perioperative Myocardial Infarction Following Vascular Surgery

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider