Association of postop MI with high mortality rates after vascular surgery

Editor's Note

Despite high rates of patients discharged with cardioprotective medications, the long-term burden of postoperative myocardial infarction (MI) after major vascular surgery is substantial, with a high mortality rate in the following year, this study finds.

Of 26,231 vascular surgery patients analyzed, factors linked to an increased risk of postoperative MI included, increased age, diabetes, coronary artery disease, congestive heart failure, cardiac valvular disease, and preoperative use of P2Y12 platelet inhibitors.

Patients who experienced a postoperative MI within 1 year after surgery had a very high 37% mortality rate. Those who had a postoperative MI associated with ECG changes or troponin elevation only, continued to have an elevated risk of mortality as long as 5 years after surgery.

The persistently high rates of mortality after postoperative MI, even when receiving appropriate medical therapy, demonstrate the need for intense follow-up after discharge and the need for novel therapies for these patients, the authors say.