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Perioperative myocardial infarction (MI) is associated with substantial morbidity and mortality. Using data from the POISE trial (in which patients undergoing noncardiac surgery were randomized to metoprolol or placebo; JW Gen Med May 22 2008), researchers evaluated MI outcomes of patients within 30 days of surgery.
Among more than 8000 patients, 5% suffered perioperative MIs (defined by elevations in troponin or creatine kinase–MB levels). Of these patients, 35% experienced ischemic symptoms, and 65% exhibited electrocardiogram changes but no symptoms. Thirty-day mortality was significantly higher among patients who experienced perioperative MIs than among those who did not (11.6% vs. 2.2%). Among patients who experienced perioperative MIs,…