Myocardial reinfarction after anesthesia and surgery

Abstract

A total of 587 patients who had suffered previous myocardial infarctions underwent anesthesia and surgery. Thirty-six (6.1%) had a reinfarction and 25 (69%) died. Patients operated on within 3 mo. of the previous infarction had a 27% reinfarction rate. This decreased to 11% if the infarct had occurred 3-6 mo. previously and stabilized at 4%-5% if the interval was more than 6 mo. Risk factors associated with significantly increased reinfarction rates included preoperative hypertension, intraoperative hypotensive episodes and noncardiac thoracic or upper abdominal operations of more than 3 h duration. Time under anesthesia was strikingly correlated with reinfarction rates in the entire group. Postoperative intensive care unit admission did not significantly affect the reinfarction rate, nor did diabetes, angina, patient age or sex, or site of the previous myocardial infarction.