Relationship of unrecognised myocardial infarction, diabetes mellitus and type of surgery to postoperative cardiac outcomes in vascular surgery

Eur J Vasc Endovasc Surg. 2001 Jan;21(1):9-16. doi: 10.1053/ejvs.2000.1213.


Objectives: to evaluate preoperative clinical, surgical and instrumental variables as predictors of postoperative cardiac events in patients undergoing different types of elective major vascular surgery.

Material and methods: on the basis of an algorithm including clinical and test echocardiographic data, we prospectively stratified 604 consecutive patients into low, intermediate and high-risk groups. The value of the variables in predicting postoperative cardiac events was assessed by means of multivariate analysis.

Results: there were 16 major postoperative cardiac events and six of 16 postoperative deaths were cardiac related (1%). Significant predictors of cardiac complications were unrecognised myocardial infarction (odds ratio - (OR) 5.6), coronary artery disease (OR 2.5), severe hypertension (OR 2.1) and peripheral vascular surgery (OR 1.9). In the intermediate-risk group, the best correlates with cardiac complications were unrecognised myocardial infarction (OR 3.3) and diabetes (OR 2.5).

Conclusions: our results suggest the importance of identifying patients with unrecognised ischaemic heart disease and of using aggressive perioperative protocols for managing diabetic patients undergoing peripheral vascular procedures.

MeSH terms

  • Aged
  • Algorithms
  • Cause of Death
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / mortality*
  • Echocardiography
  • Female
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / mortality*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / mortality*
  • Risk
  • Survival Analysis
  • Vascular Surgical Procedures*