INCIDENCE OF PERIOPERATIVE MYOCARDIAL-ISCHEMIA IN TURF PATIENTS

Study Objective: To determine the incidence of new episodes of myocard ial ischemia in patients undergoing transurethral resection of the pro state (TURP). Design: Prospective, nonrandomized study. Setting: Veter ans Administration medical center. Patients: 39 patients undergoing el ective TURP Interventions: None. Measurements and Main Results: Myocar dial ischemia was detected with a 3-channel ambulatory ECG recorded. T he ambulatory ECG recorder was applied preoperatively and removed when the patient left the recovery room. New myocardial ischemia was defin ed a sa 1 mm or greater ST depression or a 2 mm or greater ST elevatio n from baseline, lasting for 1 minute or longer in at least one lead a t the J point plus 60 msec unless this point fell within the T wave, i n which case the J point 40 msec or greater was used. ST changes consi stent with myocardial ischemia were confirmed by a cardiologist blinde d to the patient's clinical course. Seven of 39 TURP patients (18%) ha d ST segment changes indicative of new myocardial ischemia. These seve n patients had more prostate tissue resected and more blood loss than the 32 patients who did not have any myocardial ischemia (p < 0.05). C onclusions: Patients undergoing TURP have an 18% incidence of myocardi al ischemia. Patients undergoing TURP with more prostate tissue resect ed and greater blood loss are at increased risk for perioperative myoc ardial ischemia. (C) 1996 by Elsevier Science Inc.