Links Between the OR and Outcomes: Intraoperative Hypotension and Perioperative Myocardial Infarction

In this issue of Anesthesia & Analgesia, Hallqvist et al perform a nested case-control study assessing patients who suffered acute, perioperative myocardial infarction after undergoing noncardiac surgery. Patients were identified from the registries of 3 university hospitals in Sweden from 2007 to 2014. They were matched to controls based on age, sex, ASA class, cardiovascular disease, surgical year, hospital, surgical code, acuity of surgery, and surgical duration. The authors explored the relationship of intraoperative hypotension to the consequent risk of acute MI. Reductions in blood pressure were defined relative to baseline values obtained from ≥5 prior readings within 2 months of presenting for surgery. As this infographic summarizes, reductions in blood pressure from baseline of 41 to 50 mm Hg resulted in a 3-fold risk of developing acute myocardial infarction, and further reductions significantly amplified this risk. The reader is strongly encouraged to pursue and in-depth understanding of these findings by reviewing the article and its attendant editorial.