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Adverse cardiac outcomes after pulmonary function testing with recent myocardial infarction

Thomas Altree1, Lauren Bussell1, Phan Nguyen2

  • 1The Department of Thoracic Medicine, The Royal Adelaide Hospital, Port Rd, Adelaide, South Australia, 5000, Australia.

Respiratory Medicine
|July 13, 2019
PubMed

Insights

Pulmonary function testing (PFT) after myocardial infarction (MI) is listed as a contraindication. This study found PFTs to be safe within one month of MI before coronary artery bypass graft surgery, with no adverse cardiac events observed.

Area of Science:

  • Cardiology
  • Pulmonology
  • Critical Care Medicine

Background:

  • Current guidelines contraindicate pulmonary function testing (PFT) within one month of myocardial infarction (MI) based on expert opinion.
  • The safety of performing PFTs in patients with recent MI prior to major cardiac surgery remains unclear.

Purpose of the Study:

  • To evaluate the safety and impact of pulmonary function testing (PFT) performed within one month of myocardial infarction (MI) in patients undergoing Coronary Artery Bypass Graft (CABG) surgery.

Main Methods:

  • Retrospective review of 136 patients undergoing CABG surgery.
  • Identified 21 patients who underwent PFTs within one month of MI (MI + PFT group).
  • Compared post-operative outcomes between the MI + PFT group and other CABG patients.

Main Results:

  • The MI + PFT group experienced zero incidence of MI or serious cardiac arrhythmia between PFTs and surgery.
  • No significant differences were observed in post-operative outcomes between the MI + PFT group and the general CABG patient cohort.
  • This suggests PFTs may be safe in the early post-MI period for select patients.

Conclusions:

  • Pulmonary function testing (PFT) appears to be safe within one month of myocardial infarction (MI) in patients subsequently undergoing Coronary Artery Bypass Graft (CABG) surgery.
  • The findings challenge the current guideline contraindication for PFTs in the early post-MI period.
  • Further prospective studies are warranted to confirm these findings in larger patient populations.

Keywords:
Chronic obstructive pulmonary diseasePre-operative assessmentPulmonary function testingSpirometry

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