[Correlation between prior coronary revascularization and perioperative cardiac events in patients for noncardiac surgery].
We evaluated the influence of interval between prior coronary revascularization and subsequent noncardiac surgery on perioperative cardiac events. We retrospectively identified 162 consecutive patients with previous revascularization procedures who had undergone noncardiac surgery. Postoperative cardiac complications occurred in 10 (6.2%) patients, cardiac death in 1 patient, and significant arrhythmia in 3 patients. These patients had higher rates of unstable angina, myocardial infarction within 3 months, cerebrovascular disease, peripheral vascular disease, renal dysfunction (Cr > or = 1.9 mg.dl-1) and higher preoperative risk scores as described by the Cleveland Clinic (P < 0.05). Also, the incidence of cardiac complications increased when noncardiac surgery was performed within 1 week of previous percutaneous transluminal coronary angioplasty (PTCA) and in more than 5 years after coronary artery bypass grafting or PTCA (P < 0.05). Although PTCA is widely accepted, especially in Japan, early lesion progression was observed during the first several days and atherosclerotic progression was apparent in more than 5 years after the procedure. Therefore, the time between coronary revascularization and noncardiac surgery, as well as atherosclerotic risk factors, is important in evaluating patients with history of previous revascularization procedures.
Baba
T
T
Department of Anesthesiology, Kumamoto Chuo Hospital, Kumamoto 862-0965.
Goto
T
T
Tanabe
Y
Y
Shibata
Y
Y
Homma
K
K
D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000601:surgery*; D009204:Myocardial Revascularization; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012306:Risk; D013514:Surgical Procedures, Operative; D013997:Time Factors