Abstract
Background: The incidence of perioperative myocardial infarction (PMI) is 5-35% after high-risk vascular surgeries, and increases mortality. We sought to determine the incidence of PMI after abdominal aortic aneurysm (AAA) and lower extremity revascularization (LE) procedures in current practice and describe the potential benefit of coronary revascularization. Methods: We analyzed the Nationwide Inpatient Sample from 1998 - 2006. Adult records were selected for indicating AAA and LE procedures. This group was queried for acute myocardial infarction and either percutaneous coronary intervention or coronary artery bypass grafting. In-hospital mortality was determined. We compared categorical data using the Chi-square test. Results: The incidence of PMI was 2.4% (6755/269100) overall, in-hospital mortality increased with PMI. Revascularization was associated with decreased mortality. Conclusion: In contemporary US practice, PMI appears to be under-diagnosed in this sample compared to previous prospective studies, and continues to be associated with increased in-hospital mortality. The utilization of coronary revascularization was associated with decreased mortality. Due to the retrospective nature of this study, causation cannot be determined.
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