Sj. Howell et al., PREDICTORS OF POSTOPERATIVE MYOCARDIAL-ISCHEMIA - THE ROLE OF INTERCURRENT ARTERIAL-HYPERTENSION AND OTHER CARDIOVASCULAR RISK-FACTORS, Anaesthesia, 52(2), 1997, pp. 107-111
One hundred and eighty-three patients were studied to examine the role
of a number of risk factors in the development of silent ischaemia af
ter general anaesthesia for general and vascular surgery. We collected
evidence of cardiovascular risk factors using a binary questionnaire.
The patients were monitored pre- and postoperatively using a Holter E
CG monitor. Usable data were collected on 140 patients. Pre-operative
silent myocardial ischaemia was found to be strongly associated with p
ostoperative silent myocardial ischaemia (odds ratio: 10.8, 95% confid
ence intervals: 3.8-30.7). A history of hypertension, indicated by tre
atment with antihypertensive drugs, was associated with increased risk
(odds ratio: 2.58, 95% confidence intervals: 1.12-5.96). A linear tre
nd was found for risk associated with increasing admission systolic bl
ood pressure (odds ratio: 1.20 for each 10-mmHg increase in systolic p
ressure, 95% confidence intervals: 1.01-1.42). An association between
vascular surgery and postoperative silent myocardial ischaemia was als
o confirmed (odds ratio: 2.36, 95% confidence intervals: 1.1-5.1).