Coronary angiography and failure to rescue after postoperative myocardial infarction in patients with coronary stents undergoing noncardiac surgery.

Abstract:

BACKGROUND:We evaluated coronary angiography use among patients with coronary stents suffering postoperative myocardial infarction (MI) and the association with mortality. METHODS:Patients with prior coronary stenting who underwent inpatient noncardiac surgery in Veterans Affairs hospitals between 2000 and 2012 and experienced postoperative MI were identified. Predictors of 30-day post-MI mortality were evaluated. RESULTS:Following 12,096 operations, 353 (2.9%) patients had postoperative MI and 58 (16.4%) died. Post-MI coronary angiography was performed in 103 (29.2%) patients. Coronary angiography was not associated with 30-day mortality (odds ratio [OR]: .70, 95% CI: .35-1.42). Instead, 30-day mortality was predicted by revised cardiac risk index ≥3 (OR 1.91, 95% CI: 1.04-3.50) and prior bare metal stent (OR 2.12, 95% CI: 1.04-4.33). CONCLUSIONS:Less than one-third of patients with coronary stents suffering postoperative MI underwent coronary angiography. Significant predictors of mortality were higher revised cardiac risk index and prior bare metal stent. These findings highlight the importance of comorbidities in predicting mortality following postoperative MI.

journal_name

Am J Surg

authors

Hollis RH,Holcomb CN,Valle JA,Smith BP,DeRussy AJ,Graham LA,Richman JS,Itani KM,Maddox TM,Hawn MT

doi

10.1016/j.amjsurg.2016.07.023

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

814-822.e1

issue

5

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(16)30438-X

journal_volume

212

pub_type

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