Management of perioperative myocardial infarction in noncardiac surgical patients.
Perioperative myocardial infarction (PMI) is a major cause of morbidity and mortality in patients undergoing noncardiac surgery. The incidence of PMI varies depending on the method used for diagnosis and is likely to increase as the population ages. Studies have examined different methods for prevention of myocardial infarction (MI), including the use of perioperative beta-blockers, alpha(2)-agonists, and statin therapy. However, few studies have focused on the treatment of PMI. Current therapy for acute MI generally involves anticoagulation and antiplatelet therapy, raising the potential for surgical site hemorrhage in this population. This article reviews the possible mechanisms, diagnosis, and treatment options for MI in the surgical setting. We also suggest algorithms for treatment.
Adesanya
Adebola O
AO
Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, 75390, USA. adebola.adesanya@utsouthwestern.edu
de Lemos
James A
JA
Greilich
Nancy B
NB
Whitten
Charles W
CW
D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D006801:Humans; D015994:Incidence; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D019990:Perioperative Care / Q000379:methods*; D011379:Prognosis; D012307:Risk Factors; D013514:Surgical Procedures, Operative
D002317:Cardiovascular Agents