Key result
Major peri-operative cardiac events occur in 3.9% of at-risk patients and are associated with 15-25% in-hospital mortality and subsequent cardiovascular death or MI at 6 months (HR 18; 95% CI 6-57).
This paper reviews the pathophysiology, definitional flaws, and management of peri-operative myocardial infarction, a complication with high mortality.
High peri-operative cardiac event mortality warrants vigilant monitoring in at-risk patients; leaves optimal prevention strategies open pending prospective trials.
Patients with, or at risk for, cardiac disease have a 3,9% (95% confidence interval (CI) 3,3% – 4,6%) chance of suffering a major peri-operative cardiac event.1 This is associated with a significant in-hospital mortality of 15 - 25%, and subsequent cardiovascular death or myocardial infarction at 6 months (hazard ratio 18; 95% CI 6 – 57).1 This paper focuses on our understanding of the pathophysiology of peri-operative myocardial infarction, the flaws associated with the proposed definition of peri-operative myocardial infarction, and the management of peri-operative myocardial infarction.
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Bruce Biccard (2010) conducted a review in Peri-operative myocardial infarction. Peri-operative myocardial infarction was evaluated. Major peri-operative cardiac events occur in 3.9% of at-risk patients and are associated with 15-25% in-hospital mortality and subsequent cardiovascular death or MI at 6 months (HR 18; 95% CI 6-57).
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