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. 2021 Mar;49(3):300060521992995.
doi: 10.1177/0300060521992995.

Characteristics and long-term mortality of patients with ST-elevation or non-ST-elevation myocardial infarction after orthopaedic surgery

Wenlan Hu  1 , Kaiping Zhao  2 , Youzhou Chen  1 , Jihong Wang  1 , Mei Zheng  1 , Ying Zhao  1 , Qiong Zhao  3 , Xingshan Zhao  1
Affiliations

Characteristics and long-term mortality of patients with ST-elevation or non-ST-elevation myocardial infarction after orthopaedic surgery

Wenlan Hu et al. J Int Med Res. 2021 Mar.

Abstract

Objective: To investigate the clinical characteristics and long-term mortality of patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) after orthopaedic surgery.

Methods: This retrospective, single-centre study enrolled patients that underwent inpatient orthopaedic surgery from 2009 to 2017 in Beijing Jishuitan Hospital. The patients were screened for a cardiac troponin I elevation and fulfilled the Fourth Universal Definition of Myocardial Infarction within 30 days of surgery.

Results: A total of 180 patients that developed perioperative myocardial infarction (MI) were included in the study. Among them, 14 patients (7.8%) were classified as STEMI, and 166 (92.2%) had NSTEMI. Compared with those with NSTEMI, STEMI patients had significantly higher 30-day and long-term mortality rates (50.0% versus 5.4%; 71.4% versus 22.3%; respectively). Multivariate Cox regression model analysis among the entire cohort demonstrated that STEMI (hazard ratio [HR] 5.78, 95% confidence interval [CI] 2.50, 13.38) and prior MI (HR 2.35, 95% CI 1.02, 5.38) were the most significant independent predictors of long-term mortality.

Conclusion: Perioperative MI after orthopaedic surgery was associated with a high mortality rate. STEMI was independently associated with a significant increase in short- and long-term mortality.

Keywords: NSTEMI; Perioperative; STEMI; myocardial infarction; orthopaedic surgery.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there are no conflicts of interest.

Figures

Figure 1.
Figure 1.
Study flow chart showing the numbers of patients screened and the final study population. MI, myocardial infarction; STEMI, ST-elevation myocardial infarction; NSTEMI, non-ST-elevation myocardial infarction.
Figure 2.
Figure 2.
Kaplan‒Meier survival curves illustrating the risk of long-term death from any cause shown for patients (n = 180) that underwent orthopaedic surgery and experienced a perioperative myocardial infarction (MI) stratified according to the classification of the MI as ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI).
See this image and copyright information in PMC

References

    1. Lowe HC, Freedman SB. What do we know about perioperative ischaemic cardiac events in patients undergoing non-cardiac surgery? Med J Aust 2006; 184: 376–377. - PubMed
    1. Chong CP, van Gaal WJ, Savige J, et al. Cardiac injury and troponin testing after orthopaedic surgery. Injury 2011; 42: 855–863. - PubMed
    1. Kristensen SD, Knuuti J, Saraste A, et al. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J 2014; 35: 2383–2431. - PubMed
    1. Leppo JA. Preoperative cardiac risk assessment for noncardiac surgery. Am J Cardiol 1995; 75: 42D–51D. - PubMed
    1. Landesberg G, Beattie WS, Mosseri M, et al. Perioperative myocardial infarction. Circulation 2009; 119: 2936–2944. - PubMed

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