Reinfarction Following Anesthesia in Patients with Myocardial Infarction

Abstract

The incidence of and factors related to recurrent perioperative myocardial infarction were studied retrospectively (group 1) and prospectively (group 2). Reinfarction occurred in 28 of 364 (7.7%) patients in group 1 and 14 of 733 (1.9%) in group 2 (P < 0.005). When the previous infarction was 0-3 and 4-6 mo. old, perioperative reinfarction occurred in 36% and 26% of group 1 patients, respectively, and only 5.7% and 2.3% of group 2 patients, respectively (P < 0.05). In both groups, patients with associated congestive heart failure had a higher reinfarction rate. Patients who had intraoperative hypertension and tachycardia or hypotension develop had a higher incidence of reinfarction in both groups. Preoperative optimization of the patient''s status, aggressive invasive monitoring of the hemodynamic status and prompt treatment of any hemodynamic aberration may be associated with decreased perioperative morbidity and mortality in patients with previous myocardial infarction. Which of these factors, if any, contributed to the improved outcome was not determined.