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BJA Advance Access originally published online on May 28, 2004
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British Journal of Anaesthesia, 2004, Vol. 93, No. 1 3-8
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia

Perioperative myocardial injury: individual and population implications

S. J. Howell*,1 and J. W. Sear2

1 Academic Unit of Anaesthesia, University of Leeds, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK. 2 Nuffield Department of Anaesthetics, University of Oxford, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK

*Corresponding author. E-mail: s.howell@leeds.ac.uk

The first 150 words of the full text of this article appear below.


   Introduction
 
It is generally understood that patients who have cardiovascular disease are at risk of cardiac complications after surgery.33 In patients undergoing major or vascular surgery, the risk of such complications can be significant. Eagle and colleagues studied patients enrolled on the CASS (Coronary Artery Surgery Study) registry who subsequently underwent non-cardiac surgery. They reported a perioperative myocardial infarction rate of 8.5% in patients with medically managed coronary artery disease who underwent vascular surgery.14 The authors defined high-risk surgery as surgery associated with a risk of perioperative death or myocardial infarction of greater than 4%. Abdominal surgery, thoracic surgery, and head and neck surgery fell into this category. For patients undergoing these types of surgery who had medically treated coronary artery disease, the overall perioperative myocardial infarction rate was 2.7% and the overall death rate 3.3%. This compared with rates of 0.8 and 1% respectively in patients undergoing similar surgery who . . . [Full Text of this Article]


   Perioperative cardiac events: the population burden of disease
 

   Preventing perioperative cardiac events: the population perspective
 

   Risk scoring
 

   The long-term implications of surgery
 

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