This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shah, K. B. Articles by Schaafsma, M. Search for Related Content PubMed PubMed Citation Articles by Shah, K. B. Articles by Schaafsma, M.

Angina and Other Risk Factors in Patients With Cardiac Diseases Undergoing Noncardiac Operations

Received from Loyola University Medical Center, Departments of Anesthesiology and of Surgery and Physiology, Maywood, Illinois, and Hines Veterans Administration Hospital, Hines, Illinois.

Abstract

Six hundred eighty-eight consecutive patients with cardiac diseases or who wer, 'older than 70 yr of age, all of whom were undergoing noncardiac operations, were studied. Twenty-four preopeiative risk factors were analyzed for the outcome of perioperative myocardial infarction (PMI) or cardiac death using stepwise logistic regression. Old age, emergency operation, angina, previous myocardial infarction, electrocardiographic signs of ischemia, type of surgical procedure, and hypokalemia were identified as individual factors useful in predicting outcome. Thirty-two patients (4.65%) developed PMI. Seven of these 32 patients (21.9%) and eight more patients without PMI—a total of 15 patients (2.2%)—died a cardiac death. Nonfatal but serious complications occurred in 23% of the patients. Patients undergoing emergency operations and patients with chronic stable angina, previous myocardial infarction, and electrocardio- graphic signs of ischemia were found to be at increased risk for PMI and cardiac death.

Key Words: HEART, ISCHEMIA—operative risk • RISK, PERIOPERATIVE—angina

This article has been cited by other articles:

				Authors/Task Force Members, D. Poldermans, J. J. Bax, E. Boersma, S. De Hert, E. Eeckhout, G. Fowkes, B. Gorenek, M. G. Hennerici, B. Iung, et al. Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery: The Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-cardiac Surgery of the European Society of Cardiology (ESC) and endorsed by the European Society of Anaesthesiology (ESA) Eur. Heart J., November 2, 2009; 30(22): 2769 - 2812. [Full Text] [PDF]

				L. A. FLEISHER Cardiac risk stratification for noncardiac surgery: Update from the American College of Cardiology/American Heart Association 2007 guidelines Cleveland Clinic Journal of Medicine, November 1, 2009; 76(Suppl_4): S9 - S15. [Abstract] [Full Text] [PDF]

				P.J. Devereaux, L. Goldman, D. J. Cook, K. Gilbert, K. Leslie, and G. H. Guyatt Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk Can. Med. Assoc. J., September 13, 2005; 173(6): 627 - 634. [Abstract] [Full Text] [PDF]

				T. S. Maldonado, R. Moreno, P. J. Gagne, M. A. Adelman, M. M. Nalbandian, D. Bajakian, G. R. Jacobowitz, P. J. Lamparello, T. S. Riles, and C. B. Rockman Successful Management of Carotid Stenosis in a High-Risk Population at an Inner-City Hospital Vascular and Endovascular Surgery, November 1, 2004; 38(6): 511 - 517. [Abstract] [PDF]

				S. J. Howell, J. W. Sear, and P. Foex Hypertension, hypertensive heart disease and perioperative cardiac risk{dagger} Br. J. Anaesth., April 1, 2004; 92(4): 570 - 583. [Abstract] [Full Text] [PDF]

				D. D. Mathes The Preoperative Evaluation of the Patient With Cardiac Risk Factors for Noncardiac Surgery: Which Patients Need Further Cardiac Risk Stratification Tests? Seminars in Cardiothoracic and Vascular Anesthesia, July 1, 2001; 5(2): 154 - 165. [Abstract] [PDF]

				J. P Reginelli and R. M Mills Non-cardiac surgery in the heart failure patient Heart, May 1, 2001; 85(5): 505 - 507. [Full Text]

				W. C Krupski, M. R Nehler, T. A Whitehill, R. C Lawson, P. K Strecker, and W. R Hiatt Negative impact of cardiac evaluation before vascular surgery Vascular Medicine, February 1, 2000; 5(1): 3 - 9. [Abstract] [PDF]

				J. A. Wahr, R. Parks, D. Boisvert, M. Comunale, J. Fabian, J. Ramsay, D. T. Mangano, and for the Multicenter Study of Perioperative Ischemi Preoperative Serum Potassium Levels and Perioperative Outcomes in Cardiac Surgery Patients JAMA, June 16, 1999; 281(23): 2203 - 2210. [Abstract] [Full Text] [PDF]

				D. T. Mangano and L. Goldman Preoperative Assessment of Patients with Known or Suspected Coronary Disease N. Engl. J. Med., December 28, 1995; 333(26): 1750 - 1756. [Full Text] [PDF]