Myocardial infarction risks remain for patients undergoing noncardiac elective surgery

摘要

Washington, DC-Recent efforts to reduce the not uncommon risk of myocardial infarction in patients undergoing noncardiac surgery have turned up empty.Researchers presenting findings at the Scientific Sessions of the American College of Cardiology (ACC) in March from 2 studies using aspirin or clonidine found no reduction in the rate of composite death or nonfatal myocardial infarction among patients undergoing surgery for problems not related to cardiac problems. The findings were from the Perioperative Ischemic Evaluation (POISE-2) studies, a blinded and randomized trial with a 2-by-2 factorial design allowing for comparisons of low-dose aspirin vs placebo or low-dose clonidine vs placebo in 10 010 patients treated at 135 centers in 23 countries.Many of these researchers were also involved in the original POISE trial, which found use of a (3-blocker (extended-release metoprolol succinate) in patients undergoing noncardiac surgery did reduce risk of cardiac death, nonfatal myocardial infarction, or cardiac arrest, but it did so at the expense of increased risk of total mortality and stroke (Devereaux PJ et al. Lancet. 2008; 371[9627]:1839-1847).