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Perioperative myocardial infarction in patients undergoing myocardial revascularization surgery

Pericles Pretto1, Gerez Fernandes Martins2, Andressa Biscaro3

  • 1Hospital São José, Criciúma, SC, Brazil.

Revista Brasileira De Cirurgia Cardiovascular : Orgao Oficial Da Sociedade Brasileira De Cirurgia Cardiovascular
|April 11, 2015
PubMed

Insights

Perioperative myocardial infarction (PMI) is a significant concern after coronary artery bypass graft surgery. This study found a high frequency of PMI, linked to worse patient outcomes including reduced left ventricular function and increased mortality.

Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • Perioperative myocardial infarction (PMI) negatively impacts prognosis after coronary artery bypass graft (CABG) surgery.
  • Diagnosis of PMI is challenging due to distinct pathophysiology and clinical presentation compared to traditional atherosclerosis.

Purpose of the Study:

  • To determine the incidence and outcomes of perioperative myocardial infarction in patients undergoing coronary artery bypass graft surgery.

Main Methods:

  • Retrospective cohort study including 116 patients undergoing CABG between May 2011 and April 2012.
  • Diagnosis of PMI confirmed using the Third Universal Definition of Myocardial Infarction criteria.
  • Analysis of factors associated with PMI and patient outcomes.

Main Results:

  • Perioperative myocardial infarction was diagnosed in 24.1% of patients (28/116).
  • Factors associated with PMI included number of grafts, cardiopulmonary bypass time, and higher mean patient age.
  • Elevated troponin I was observed in 99.1% of cases, irrespective of PMI diagnosis. Patients with PMI showed worse left ventricular function and higher mortality.

Conclusions:

  • The study identified a high frequency of perioperative myocardial infarction following CABG.
  • PMI is associated with adverse outcomes, including impaired left ventricular function and increased mortality.
Abstract

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