Perioperative Myocardial Infarction: What's a Clinician to Do?

MI after noncardiac surgery is associated with increased risk for death, but whether routine measurement of cardiac biomarkers can improve outcomes is unclear.

In the placebo-controlled, randomized, POISE (PeriOperative ISchemic Evaluation) trial, perioperative beta-blockers were found to be of no benefit in 8351 patients undergoing noncardiac surgery (JW Cardiol May 14 2008). Per protocol, cardiac biomarker levels (troponin or creatine kinase–MB) were measured 6 to 12 hours after surgery and on postoperative days 1, 2, and 3. In this substudy, investigators examined the association of perioperative myocardial infarction (MI), established by predefined criteria within 30 days after randomization, with mortality in the POISE cohort.

A total of 415 patients (5%) had perioperative MI. Events occurred within 48 hours after surgery in 64.6% of patients with symptomatic MI and 79.3% of those with asympto…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute