Incomplete Revascularization May Lead to Higher Rates of MI Following Non-Cardiac Surgery

Patients with coronary artery disease (CAD) who had incomplete revascularization may be at a higher risk of myocardial infarction (MI) after non-cardiac surgery, according to the results of research presented Nov. 14 during AHA 2016 and simultaneously published in JACC: Cardiovascular Interventions.

Ehrin J. Armstrong, MD, MSc, FACC, et al., assessed the major adverse cardiovascular events that occurred in 4,332 patients with CAD who had incomplete revascularization and underwent non-cardiac surgery within two years after stent placement. Incomplete revascularization was defined as residual stenosis of greater than or equal to 50 percent in the left main coronary artery or greater than or equal to 70 percent in another major epicardial coronary artery based on operator visual estimate.

The results of the study showed that patients with incomplete revascularization were at a significantly increased risk of post-operative MI primarily if the surgery was performed within six weeks after percutaneous coronary intervention. Further, for each additional vessel with incomplete revascularization, there was 17 percent increased risk of post-operative MI.

“While this study establishes the relationship, it's therapeutic implications are unclear,” commented Kim A. Eagle, MD, MACC, editor-in-chief of

Clinical Topics: Invasive Cardiovascular Angiography and Intervention, Atherosclerotic Disease (CAD/PAD), Interventions and Coronary Artery Disease

Keywords: AHA16, American Heart Association, AHA Annual Scientific Sessions, Constriction, Pathologic, Coronary Artery Disease, Heart, Myocardial Infarction, Percutaneous Coronary Intervention, Stents

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