Perioperative Myocardial Infarction in Patients Undergoing Noncardiac Surgery
Authors: Darryl Potyk
Journal: Annals of Internal Medicine (2011)

Letters4 October 2011Perioperative Myocardial Infarction in Patients Undergoing Noncardiac SurgeryDarryl Potyk, MD, FACPDarryl Potyk, MD, FACPFrom Internal Medicine Residency Spokane, University of Washington School of Medicine, Spokane, WA 99204.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-7-201110040-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I read the recent article by Devereaux and colleagues (1) regarding perioperative myocardial infarction (MI) with interest. Although the cohort data presented derive from a large prospective, randomized, controlled trial, the authors' findings are consistent with and confirm those of prior studies regarding perioperative myocardial ischemia and infarction—namely, that perioperative MIs are common, often clinically silent, and associated with significant mortality (2, 3).A notable finding is that increased preoperative or baseline heart rate was an independent risk factor for perioperative MI. Although the authors acknowledge this as a potentially modifiable risk factor, they refrain from commenting ...References1. Devereaux PJ, Xavier D, Pogue J, Guyatt G, Sigamani A, Garutti I, et al; POISE (PeriOperative ISchemic Evaluation) Investigators. Characteristics and short-term prognosis of perioperative myocardial infarction in patients undergoing noncardiac surgery: a cohort study. Ann Intern Med. 2011;154:523-8. [PMID: 21502650] LinkGoogle Scholar2. Landesberg G, Luria MH, Cotev S, Eidelman LA, Anner H, Mosseri M, et al. Importance of long-duration postoperative ST-segment depression in cardiac morbidity after vascular surgery. Lancet. 1993;341:715-9. [PMID: 8095624] CrossrefMedlineGoogle Scholar3. Mangano DT. Perioperative cardiac morbidity. Anesthesiology. 1990;72:153-84. [PMID: 2404426] CrossrefMedlineGoogle Scholar4. Devereaux PJ, Yang H, Yusuf S, Guyatt G, Leslie K, Villar JC, et al; POISE Study Group. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet. 2008;371:1839-47. [PMID: 18479744] CrossrefMedlineGoogle Scholar5. Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof EL, Chaikof E, et al; American College of Cardiology. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery. J Am Coll Cardiol. 2007;50:159-241. [PMID: 17950140] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Internal Medicine Residency Spokane, University of Washington School of Medicine, Spokane, WA 99204.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCharacteristics and Short-Term Prognosis of Perioperative Myocardial Infarction in Patients Undergoing Noncardiac Surgery P.J. Devereaux , Denis Xavier , Janice Pogue , Gordon Guyatt , Alben Sigamani , Ignacio Garutti , Kate Leslie , Purnima Rao-Melacini , Sue Chrolavicius , Homer Yang , Colin MacDonald , Alvaro Avezum , Luc Lanthier , Weijiang Hu , Salim Yusuf , and Perioperative Myocardial Infarction in Patients Undergoing Noncardiac Surgery P.J. Devereaux , Gordon Guyatt , and Salim Yusuf Metrics 4 October 2011Volume 155, Issue 7Page: 477KeywordsCardiac surgeryIschemiaMedical risk factorsMorbidityMyocardial infarctionReasoningSurgeryThoracic surgeryTroponin ePublished: 4 October 2011 Issue Published: 4 October 2011 CopyrightCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...