TY - JOUR
T1 - Reducing Perioperative Myocardial Infarction Following Vascular Surgery
T2 - The Potential Role of β-Blockade
AU - Yeager, Richard A.
AU - Moneta, Gregory L.
AU - Edwards, James M.
AU - Taylor, Lloyd M.
AU - McConnell, Donald B.
AU - Porter, John M.
N1 - Funding Information:
Supported by grant RR-00334 from the Clinical Re-
Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 1995/8
Y1 - 1995/8
N2 - To determine which perioperative variables may influence the occurrence of perioperative myocardial infarction (PMI) following vascular surgery. Case-contol study. Combined Veterans Affairs Medical Center university hospital vascular service. During a 4-year period, all major vascular surgical operations (N=2088) were evaluated with serial postoperative electrocardiography and cardiac enzyme measurements. Patients with PMI following nonemergent vascular surgery (N=53) were matched with randomly selected control patients without PMI (N=106) for age, gender, type of operation, hypertension, and symptoms of coronary artery disease. The two groups were compared for operative blood loss, blood pressure, and heart rate as well as length of operation, type of anesthetic, and use of perioperative β-blockers, nitroglycerine, calcium channel blockers, vasopressors, and angiotensinconverting enzyme inhibitors. β-Blockers were used less frequently in patients with PMI than in control patients without PMI (30% vs 50%; P=.01). Overall β-blockade was associated with a 50% reduction in PMI (P=.03). Perioperative myocardial infarction was not associated with length of operation, type of anesthetic, blood pressure, or use of other medications. β-Blockade is associated with a decreased incidence of PMI in patients undergoing vascular surgery. Prophylactic perioperative use of β-blockers may decrease PMI in patients requiring major vascular surgery. A prospective randomized trial of β-blockers in these patients appears to be warranted.
AB - To determine which perioperative variables may influence the occurrence of perioperative myocardial infarction (PMI) following vascular surgery. Case-contol study. Combined Veterans Affairs Medical Center university hospital vascular service. During a 4-year period, all major vascular surgical operations (N=2088) were evaluated with serial postoperative electrocardiography and cardiac enzyme measurements. Patients with PMI following nonemergent vascular surgery (N=53) were matched with randomly selected control patients without PMI (N=106) for age, gender, type of operation, hypertension, and symptoms of coronary artery disease. The two groups were compared for operative blood loss, blood pressure, and heart rate as well as length of operation, type of anesthetic, and use of perioperative β-blockers, nitroglycerine, calcium channel blockers, vasopressors, and angiotensinconverting enzyme inhibitors. β-Blockers were used less frequently in patients with PMI than in control patients without PMI (30% vs 50%; P=.01). Overall β-blockade was associated with a 50% reduction in PMI (P=.03). Perioperative myocardial infarction was not associated with length of operation, type of anesthetic, blood pressure, or use of other medications. β-Blockade is associated with a decreased incidence of PMI in patients undergoing vascular surgery. Prophylactic perioperative use of β-blockers may decrease PMI in patients requiring major vascular surgery. A prospective randomized trial of β-blockers in these patients appears to be warranted.
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U2 - 10.1001/archsurg.1995.01430080071011
DO - 10.1001/archsurg.1995.01430080071011
M3 - Article
C2 - 7632148
AN - SCOPUS:0029038008
SN - 0004-0010
VL - 130
SP - 869
EP - 873
JO - Archives of Surgery
JF - Archives of Surgery
IS - 8
ER -