Reevaluation of perioperative myocardial infarction in patients with prior myocardial infarction undergoing noncardiac operations.

We studied 275 patients with prior myocardial infarctions undergoing noncardiac operations to determine the incidence and outcome of perioperative myocardial reinfarction. Perioperative myocardial reinfarction developed in 13 patients (4.7%) of whom 3 (23%) died of cardiac causes. When time between prior myocardial infarction and the date of anesthesia was analyzed, the incidence of perioperative myocardial reinfarction was 4.3% at 0-3 mo, 0 at 4-6 mo, 5.7% at greater than 6 mo, and 3.3% at an indeterminate exact interval. None of the variables analyzed showed any significant correlation with the rate of reinfarction. The urgency of operation and aortic or vascular procedures were the only variables that approached, but failed to achieve, statistical significance.