Incidence of Perioperative Myocardial Infarction in Patients Who Underwent Preoperative Evaluation by Internist for Intermediate and High Risk Non-Cardiac Surgery
Pawin Sirisaengchaikul MD*, Ing-orn Arunakul MD**
Affiliation : * Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand ** Division of Cardiology, Department of Medicine, Faculty of Medicine, Thammasat University, Bangkok, Thailand
Background : Incidence of perioperative myocardial infarction (PMI) in patients who underwent intermediate to high risk
surgery is varied from 1 to 9 percent based on previous studies.
Objective : To study the incidence of PMI among patients who undergo preoperative evaluation by internists for intermediate
to high risk non-cardiac surgery.
Material and Method: This study is a cross-sectional study, performed at Thammasat Hospital for one year. Eligible patients
were subjects older than 20 years old who underwent elective intermediate to high risk non-cardiac surgery with preoperative
cardiovascular evaluation. The primary outcome was the incidence of PMI which diagnosed based on definition of Third
universal definition of myocardial infarction ESC/ACCF/AHA/WHF 2012. The secondary outcome was the incidence of
elevated high sensitivity cardiac Troponin T (hs-cTnT).
Results : Fourty-five patients (median age 66 years, female 68.9%) were eligible for this study. Most of them underwent
orthopedic surgery (88.9%). Three female patients developed PMI, represented as 6.7%. In multivariate logistic regression
analysis, CrCl <30 mL/min/1.73m2 was an independent factor associated with PMI [adjusted odd ratio 82.00 (95% CI 3.64-
1,846.00; p = 0.006)]. Twenty-two patients (48.9%) had elevated hs-cTnT.
Conclusion : Incidence of PMI was similar to the previous study, and eGFR less than 30 mL/min/1.73m2 was an independent
factor for PMI.
Keywords : Perioperative myocardial infarction, Preoperative evaluation
