Patients assigned to the placebo group will receive oral placebo tablets and an inert transdermal occlusive skin patch. A standardized anesthetic protocol with tight hemodynamic control will be used. Intraoperative hemodynamics will be recorded by computer. Myocardial ischemia, the primary outcome variable will be detected by continuous Holter monitoring with ST segment analysis. Holter monitoring will begin one day prior to surgery and continue for 7 days postoperatively.
All outcomes are by standardized predefined protocols consistent with prior studies.
We have studied 185 of 200 patients. The study is blinded so no results are available at this time. In the United States more than 25 million patients undergo noncardiac surgery each year. Despite significant advances in the diagnosis and therapy of coronary artery disease, the perioperative morbidity and mortality in this group remains high. Myocardial ischemia is a reversible risk factor for MI and cardiac death.