Perioperative myocardial infarction in peripheral vascular surgery

Publisher Website
Google Scholar
Abstract
We studied consecutive patients undergoing peripheral vascular surgery after excluding those who were undergoing surgery for trauma, venous surgery, and minor procedures. Patients thought to be at high risk of perioperative myocardial infarction were referred to a cardiologist for further preoperative assessment. Concentrations of creatinine kinase MB isoenzymes were measured (by Imx STAT) for the first three days after surgery, and electrocardiograms were recorded on admission, on discharge from hospital, and at doctors' discretion. Because the concentration of creatinine kinase MB isoenzyme may be raised by skeletal muscle ischaemia, myocardial infarction was diagnosed only when a raised total creatinine kinase concentration was associated with an MB subunit concentration of > 10 ng/ml and a ratio of MB subunit to total creatinine kinase of >/=5%. Cardiac death was defined as death unequivocally related to myocardial infarction, heart failure, or arrhythmia. The primary end points of our study were myocardial infarction or cardiac death within 30 days of surgery. We performed statistical analysis with the χ2 test or, when appropriate, Fisher's exact test.