Effects of myocardial infarction on perioperative cardiac complications

Of 1,104 consecutive noncardiac operations on 981 patients using general anesthesia, 63 were performed on 53 patients who had had a previous myocardial infarction. Patients with a previous infarct were compared to those with no prior infarct to determine the influence of a previous infarct on perioperative cardiac complications. Two of the 53 patients with a previous myocardial infarction (3.8%) had perioperative myocardial infarction, compared to 0.4% (4/928) of patients with no prior history of myocardial infarction (P < 0.05). Ventricular tachycardia (P < 0.05) and cardiac death (P < 0.01) were more frequent in patients with a previous myocardial infarction compared to those with no prior infarct. All pateints with a previous myocardial infarction who developed cardiac complications underwent vascular procedures (P < 0.005) and were over 77 years of age. The two patients who reinfarcted experienced intraoperative hypotension (P < 0.05). Fourteen of the 53 patients with a history of a myocardial infarction (26.4%) had previous coronary artery bypass surgery; no perioperative cardiac complications occurred in these patients.