Risk factors for perioperative myocardial ischemia in carotid artery endarterectomy.
OBJECTIVE
To identify variables associated with perioperative myocardial ischemia in patients undergoing carotid artery endarterectomy (CEA).


METHODS
Prospective, observational study.


METHODS
University-affiliated hospital operating room and intensive care unit.


METHODS
One hundred twenty-eight consecutive patients who underwent CEA during a 7-year period.


METHODS
Patients had general anesthesia with sevoflurane or isoflurane. CEA was performed by standard methods with shunting if clinically indicated. Holter electrocardiogram (ECG) monitoring was performed during surgery and 24 hours after surgery.


RESULTS
The incidence of perioperative myocardial ischemia was examined, and perioperative risk factors were analyzed. Nineteen patients (15%) showed significant perioperative ECG abnormalities indicative of myocardial ischemia (10 patients during surgery, 12 patients after surgery, and 3 patients both during and after surgery). Multivariate analysis showed perioperative myocardial ischemia to be significantly associated with a history of angina (odds ratio, 11.68; 95% confidence interval, 2.64-51.70) and a history of hypertension (odds ratio, 14.08; 95% confidence interval, 1.51-131.04).


CONCLUSIONS
The data indicate that perioperative myocardial ischemia defined as an ECG abnormality does not often occur in patients undergoing CEA. However, angina and hypertension may be important risk factors warranting further investigation.
Kawahito
Shinji
S
Department of Anesthesiology, Tojushima University School of Medicine, Kuramoto, Tokushima, Japan. kawahito@clin.med.tokushima-u.ac.jp
Kitahata
Hiroshi
H
Tanaka
Katsuya
K
Nozaki
Junpei
J
Oshita
Shuzo
S
D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D004562:Electrocardiography; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000209:etiology*; D012307:Risk Factors