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Characteristics and long-term mortality of patients with ST-elevation or non-ST-elevation myocardial infarction after
Wenlan Hu1, Kaiping Zhao2, Youzhou Chen1
1Department of Cardiology, Beijing Jishuitan Hospital, Beijing, China.
Insights
Perioperative myocardial infarction (MI) after orthopaedic surgery carries a high mortality risk. ST-elevation MI (STEMI) significantly increases both short- and long-term mortality compared to non-ST-elevation MI (NSTEMI).
Area of Science:
- Cardiology
- Orthopaedic Surgery
- Critical Care Medicine
Background:
- Perioperative myocardial infarction (MI) is a serious complication following orthopaedic surgery.
- Understanding the distinct clinical characteristics and mortality outcomes of ST-elevation MI (STEMI) versus non-ST-elevation MI (NSTEMI) in this context is crucial.
Purpose of the Study:
- To investigate the clinical features and long-term mortality associated with STEMI and NSTEMI in patients undergoing orthopaedic surgery.
- To identify independent predictors of mortality in this patient cohort.
Main Methods:
- Retrospective, single-centre study of 180 patients who developed perioperative MI within 30 days of orthopaedic surgery (2009-2017).
- Classification of MI into STEMI (14 patients) and NSTEMI (166 patients) based on cardiac troponin I elevation and diagnostic criteria.
- Multivariate Cox regression analysis to determine predictors of long-term mortality.
Main Results:
- STEMI patients exhibited significantly higher 30-day mortality (50.0% vs 5.4%) and long-term mortality (71.4% vs 22.3%) compared to NSTEMI patients.
- STEMI (HR 5.78) and prior MI (HR 2.35) were identified as independent predictors of long-term mortality.
Conclusions:
- Perioperative MI following orthopaedic surgery is associated with substantial mortality.
- STEMI is a critical independent risk factor for increased short- and long-term mortality in these patients.
Objective:
To investigate the clinical characteristics and long-term mortality of patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) after orthopaedic surgery.
Methods:
This retrospective, single-centre study enrolled patients that underwent inpatient orthopaedic surgery from 2009 to 2017 in Beijing Jishuitan Hospital. The patients were screened for a cardiac troponin I elevation and fulfilled the Fourth Universal Definition of Myocardial Infarction within 30 days of surgery.
Results:
A total of 180 patients that developed perioperative myocardial infarction (MI) were included in the study. Among them, 14 patients (7.8%) were classified as STEMI, and 166 (92.2%) had NSTEMI. Compared with those with NSTEMI, STEMI patients had significantly higher 30-day and long-term mortality rates (50.0% versus 5.4%; 71.4% versus 22.3%; respectively). Multivariate Cox regression model analysis among the entire cohort demonstrated that STEMI (hazard ratio [HR] 5.78, 95% confidence interval [CI] 2.50, 13.38) and prior MI (HR 2.35, 95% CI 1.02, 5.38) were the most significant independent predictors of long-term mortality.
Conclusion:
Perioperative MI after orthopaedic surgery was associated with a high mortality rate. STEMI was independently associated with a significant increase in short- and long-term mortality.
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