title: Risk of acute myocardial infarction after transurethral resection of prostate in elderly.
abstract: BACKGROUND
  Benign prostatic hyperplasia is a frequent disease among elderly, and is responsible for considerable disability. Benign prostatic hyperplasia can be clinically significant due to lower urinary tract symptoms that take place because the gland is enlarged and obstructs urine flow. Transurethral resection of the prostate remains the gold standard treatment for patients with moderate or severe symptoms who need active treatment or who either fail or do not want medical therapy. Moreover, perioperative and postoperative surgery complications as cardiovascular ones still occur. The incidence of acute myocardial infarction in patients undergoing transurethral resection of the prostate is controversial. The first studies showed an increase in mortality and relative risk of death from myocardial infarction in transurethral resection of the prostate group vs open prostatectomy but these results are in contrast with more recent data.
  
  
  CONCLUSIONS
  Given the conflicting evidence of the studies in the literature, in this review we are going to discuss the factors that may influence the risk of myocardial infarction in elderly patients undergoing prostate surgery. We analyzed the possible common factors that lead to the development of myocardial infarction and benign prostatic hyperplasia (cardiovascular and metabolic), the stressor factors related to prostatectomy (surgical and haemodynamic) and the risk factors specific of the elderly population (comorbidity and therapies).
  
  
  CONCLUSIONS
  Although transurethral resection of the prostate is considered at low risk for severe complications, there are several reports indicating that cardiovascular events in elderly patients undergoing this surgical operation are more common than in the general population. Several cardio-metabolic, surgical and aging-related factors may help explain this observation but results in literature are not concord, especially due to the fact that most data derive from retrospective studies in which selection bias cannot be excluded. Subsequently, further studies are necessary to clarify the incidence of acute myocardial infarction in old people.
authors.forename: Claudio
authors.initials: C
authors.lastname: de Lucia
authors.forename: Grazia Daniela
authors.initials: GD
authors.lastname: Femminella
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rengo
authors.forename: Antonio
authors.initials: A
authors.lastname: Ruffo
authors.forename: Valentina
authors.initials: V
authors.lastname: Parisi
authors.forename: Gennaro
authors.initials: G
authors.lastname: Pagano
authors.forename: Daniela
authors.initials: D
authors.lastname: Liccardo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cannavo
authors.forename: Paola
authors.initials: P
authors.lastname: Iacotucci
authors.forename: Klara
authors.initials: K
authors.lastname: Komici
authors.forename: Carmela
authors.initials: C
authors.lastname: Zincarelli
authors.forename: Carlo
authors.initials: C
authors.lastname: Rengo
authors.forename: Pasquale
authors.initials: P
authors.lastname: Perrone-Filardi
authors.forename: Dario
authors.initials: D
authors.lastname: Leosco
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Iacono
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Romeo
authors.forename: Bruno
authors.initials: B
authors.lastname: Amato
authors.forename: Nicola
authors.initials: N
authors.lastname: Ferrara
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D012307:Risk Factors; D020728:Transurethral Resection of Prostate / Q000009:adverse effects*