Key result
Low-risk procedures post-MI carry a ~5% 30-day MACE risk, similar to post-MI without surgery.
Why the study?
Although dermatologic surgery is classified as very low risk, limited evidence evaluates the risk of major adverse cardiovascular events after dermatologic surgery performed within 1 year of myocardial infarction.
Does dermatologic surgery within 1 year of myocardial infarction increase the 30-day risk of major adverse cardiovascular events compared with other very low-risk procedures or no procedure?
Cohort (n=308)
Yes
Does dermatologic surgery within 1 year of myocardial infarction increase the 30-day risk of major adverse cardiovascular events compared with other very low-risk procedures or no procedure?
These findings support the ACC/AHA classification of dermatologic surgery as a very low-risk procedure even in patients within 1 year of a myocardial infarction, though conclusions are limited by few events.
Answers are grounded in this paper and cite their sources.
Supports ACC/AHA very low-risk classification for dermatologic surgery post-MI; leaves open confirmation in larger prospective studies.
BACKGROUND: Dermatologic surgery is classified as very low risk by the American College of Cardiology/American Heart Association. Limited evidence evaluates the risk of major adverse cardiovascular events after dermatologic surgery within 1 year of myocardial infarction. OBJECTIVE: To determine major adverse cardiovascular event risk after dermatologic surgery within 1 year of myocardial infarction. Outcomes were compared with cataract surgery and endoscopies, which are also considered very low risk procedures. MATERIALS AND METHODS: Using the All of Us Research Program V8, nationwide database of 633,000 patients, the authors performed a retrospective study from 2018 to 2023. CPT and ICD-10 codes were used to retrieve data. RESULTS: Out of 308 procedures, 3 (0.97%) major adverse cardiovascular events were observed within the 30-day postoperative window in patients with or without a history of myocardial infarction. Patients undergoing procedures postmyocardial infarction appeared more likely to experience major adverse cardiovascular events than those without prior myocardial infarction (4.9% vs 0%), although not significantly more so than patients with myocardial infarction without procedures. CONCLUSION: The authors' findings are consistent with the low risk of dermatologic procedures in patients with myocardial infarction, although they are limited by the low number of major adverse cardiovascular events.
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Han et al. (2026) conducted a cohort in Patients undergoing dermatologic surgery, cataract surgery, or endoscopy with or without recent myocardial infarction (within 1 year) (n=308). Dermatologic surgery (or other very low-risk procedures) within 1 year after myocardial infarction vs. Patients without prior myocardial infarction undergoing procedures, as well as cataract surgery, endoscopies, and patients with myocardial infarction without procedures was evaluated on Postoperative major adverse cardiovascular events (MACE) within a 30-day postoperative window. Dermatologic and other low-risk procedures post-MI had a 4.9% 30-day MACE rate vs 0% without prior MI (0.97% overall across 308 procedures), not significantly higher than MI without procedures.
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