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November 10, 1978

Risnk of Myocardial Infarction With Elective Vascular Surgery

Author Affiliations

University of Arizona College of Medicine Tucson
Veterans Administration Hospital San Francisco

JAMA. 1978;240(20):2152-2153. doi:10.1001/jama.1978.03290200030007

To the Editor.—  The recent article by Steen et al (239:2566, 1978) is timely and an excellent follow-up to the earlier report by Tarhan et al (220:1451, 1972). All surgeons are aware of the risk of myocardial infarction with surgery; however, there is little information available on the risk of primary myocardial infarction with elective surgical procedures. Interestingly enough, the data presented by the authors substantiate the data we previously published regarding the risk of primary myocardial infarction postoperatively in patients undergoing elective aortobilateral femoral bypass grafting.1 The incidence in 180 patients was 3%. Analysis of the incidence of associated risk factors, including preexisting hypertension, diabetes mellitus, abnormal ECG, angina pectoris, and history of prior myocardial infarction more than six months before surgery, demonstrated that the only one showing a statistically significant correlation (x2, corrected for continuity) with the incidence of postoperative myocardial infarction was preoperative hypertension (P<.01).