Detection, prediction, and significance of perioperative myocardial infarction following aorta-coronary bypass

Fennell, William H.; Chua, K. G.; Cohen, Louis; Morgan, James I.; Karunaratne, H B; Resnekov, Leon; Al‐Sadir, Jafar; Lin, Chung-Yuan; Lamberti, John J.; Anagnostopoulos, Constantine E.

doi:10.1016/s0022-5223(19)38134-6

Cited by 41 publications

(7 citation statements)

References 20 publications

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“…This is in agreement with the data of Codd and colleagues [24], Gray and colleagues [41] and Balderman and colleagues [7]. On the other hand, Chaitman and colleagues [22], Fennell and colleagues [38], Hacker and colleagues [43] and Namay and colleagues [73], in their follow-up studies, claimed that long term survival is significantly shorter in patients who suffered PMI compared with those who did not, even when allowance is made for the higher perioperative mortality rate in the former group. In the CASS-report on 9777 patients who underwent CABG between 1974 and 1979 [84], actuarial survival, including hospital deaths, at 1, 3 and 5 years was significantly greater in patients without infarction than in patients with PMI (96%, 94% and 90% v. 78%, 74% and 69%).…”

Section: Frequency and Consequences Of Pmisupporting

confidence: 91%

“…On the other hand, previous illness such as hypertension or previous MI, diabetes mellitus or preoperative use of betablockers or anticoagulants have not been found to be independent risk factors for PMI in these patients [22,39,86,90]. Unstable angina was not associated with a higher incidence of PMI compared with patients with stable angina in the studies by Schneider, Pichard and Mindich [87] and Hultgren and colleagues [48], while Fennell and colleagues [38] and Gersh and colleagues [39] found a significant associated between unstable angina and PMI.…”

Section: Variables Associated With An Increased Risk Of Pmimentioning

confidence: 87%

“…The surgical technique, number of grafts and graft flow seem to be of importance [11,42,74,90]. Although Slogoff and Keats [90] found that the quality of a distal anastomosis, as rated by the operating surgeon before removing the aortic cross clamp, was one of the independent predictors of PMI, graft occlusion per se does not seem to influence the PMI rate [15,18,24,38].…”

Section: Variables Associated With An Increased Risk Of Pmimentioning

confidence: 99%

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Perioperative Myocardial Infarction

Haagensen¹,

Steen²

1988

British Journal of Anaesthesia

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The risk of developing myocardial infarction (MI) in connection with surgery and anaesthesia has been recognized for at least 75 years [19, 79, 93, 101]. Since then numerous reports have been published, some describing the incidence and characteristics of perioperative myocardial infarction (PMI), others the risk factors involved. To compare these publications is difficult because of the great span in years between various studies, and the variability in study conditions such as selection and size of population, the use of a retrospective or a prospective approach, variations in postoperative care, the method of diagnosis of PMI etc. These factors can at least partly explain the variability and even contradictions observed in results. In most of these studies statistical evaluation also leaves much to be desired. The questions are often multifactorial, without the appropriate tests being performed. Performing simple chi-squared tests on whether sex, age, type or duration of anaesthesia etc, influence the infarction rate, does not provide a correct picture. There is often some co-variation between many of these factors, such as duration of anaesthesia and type of surgery. Thus the papers should be evaluated critically and the effects of a single factor reported in a single paper should be interpreted with caution. Even more impressive, therefore, are the similarities in some of the results in spite of these differences in methodology, and certain trends appear in the literature that are important to the daily work of the anaesthetist. In this review we have concentrated on the epidemiological aspects of PMI and the risk factors that have practical consequences in the treatment of patients. Frontline research concerning the pathophysiology of myocardial ischaemia and infarction and possible effects of

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Section: Frequency and Consequences Of Pmisupporting

confidence: 91%

Section: Variables Associated With An Increased Risk Of Pmimentioning

confidence: 87%

Section: Variables Associated With An Increased Risk Of Pmimentioning

confidence: 99%

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Perioperative Myocardial Infarction

Haagensen¹,

Steen²

1988

British Journal of Anaesthesia

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“…The changes of CKMB and SGOT were associated with the changes on electrocardiography which is similar to the findings of Fennel et al 9 .…”

supporting

confidence: 90%

Clinical outcome in patients undergoing coronary artery bypass grafting using radial artery

Hasan

Adhikary

Rahman

2008

Bangladesh Med Res Counc Bull

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“…In a randomized trial of halothane, enflurane, isoflurane, and sufentanil, the rate of postoperative MI did not differ between the anesthetic groups, but the surgeons' estimates of the quality of the anastomoses and chronic hypertension were predictors of postoperative MI (48). Others have found that unstable angina (49) and worse New York Heart Association class (50,51) predicted increased rates of postoperative cardiac complications.…”

Section: Discussionmentioning

confidence: 95%

Predictors and Outcomes of Cardiac Complications Following Elective Coronary Bypass Grafting

Charlson

et al. 1999

Proc Assoc American Phys

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Our objective was to determine the predictors of cardiac complications among a cohort of elective coronary artery bypass graft (CABG) surgery patients and to determine the relationship of such complications to subsequent quality of life and symptoms. A total of 248 patients were enrolled and 237 completed 6 month follow-up. The combined rate of both major and minor cardiac complications was 9.7% (n = 24). Patients in this study were evaluated preoperatively, monitored intraoperatively, followed immediately postoperatively and at 6 months. Major cardiac complications accounted for 3.6% (n = 9) and minor complications for 6% (n = 15). Using multivariable logistic regression analysis, the predictors of major cardiac complications were receiving diuretics preoperatively (p = .01) and increased time during cross-clamping (p = .006). At 6 months after surgery, 19% of the patients with postoperative cardiac complications experienced worsening of symptoms, in contrast to only 8% of those without cardiac complications (p = .03). We concluded that patients who were on preoperative diuretics and those who had longer cross-clamp times were at higher risk of cardiac complications. The majority of patients who had acute cardiac complications had improved function and symptoms at 6 months postoperatively.

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Detection, prediction, and significance of perioperative myocardial infarction following aorta-coronary bypass

Cited by 41 publications

References 20 publications

Perioperative Myocardial Infarction

Perioperative Myocardial Infarction

Clinical outcome in patients undergoing coronary artery bypass grafting using radial artery

Predictors and Outcomes of Cardiac Complications Following Elective Coronary Bypass Grafting

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