Reducing Perioperative Myocardial Infarction Following Vascular Surgery

The Potential Role of β-Blockade

Richard A. Yeager, Gregory (Greg) Moneta, James Edwards, Lloyd M. Taylor, Donald McConnell, John M. Porter

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)869-873
Number of pages5
JournalArchives of Surgery
Volume130
Issue number8
DOIs
StatePublished - 1995

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Blood Vessels
Myocardial Infarction
Anesthetics
Blood Pressure
Nitroglycerin
Calcium Channel Blockers
Enzyme Inhibitors
Veterans
Coronary Artery Disease
Electrocardiography
Heart Rate
Hypertension
Incidence
Enzymes

ASJC Scopus subject areas

  • Surgery

Cite this

Reducing Perioperative Myocardial Infarction Following Vascular Surgery : The Potential Role of β-Blockade. / Yeager, Richard A.; Moneta, Gregory (Greg); Edwards, James; Taylor, Lloyd M.; McConnell, Donald; Porter, John M.

In: Archives of Surgery, Vol. 130, No. 8, 1995, p. 869-873.

Research output: Contribution to journalArticle

Yeager, Richard A. ; Moneta, Gregory (Greg) ; Edwards, James ; Taylor, Lloyd M. ; McConnell, Donald ; Porter, John M. / Reducing Perioperative Myocardial Infarction Following Vascular Surgery : The Potential Role of β-Blockade. In: Archives of Surgery. 1995 ; Vol. 130, No. 8. pp. 869-873.
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