Steen P A, Tinker J H, Tarhan S
JAMA. 1978 Jun 16;239(24):2566-70. doi: 10.1001/jama.239.24.2566.
During the years 1974 and 1975 at our institution, 587 patients who had suffered previous myocardial infarctions underwent anesthesia and surgery. Thirty-six (6.1%) had a reinfarction and 25 (69%) died. Patients operated on within three months of the previous infarction had a 27% reinfarction rate. This decreased to 11% if the infarct had occurred three to six months previously and stabilized at 4% to 5% if the interval was more than six months. Risk factors associated with significantly increased reinfarction rates included preoperative hypertension, intraoperative hypotensive episodes, and noncardiac thoracic or upper abdominal operations of more than three hours' duration. Time under anesthesia was strikingly correlated with reinfarction rates in the entire group. Postoperative intensive care unit admission did not significantly affect the reinfarction rate, nor did diabetes, angina, patient age or sex, or site of the previous myocardial infarction.
1974年至1975年期间，在我们机构，587例曾有过心肌梗死的患者接受了麻醉和手术。36例（6.1%）发生了再梗死，25例（69%）死亡。在前次梗死3个月内接受手术的患者，再梗死率为27%。如果梗死发生在3至6个月前，该比率降至11%；如果间隔超过6个月，则稳定在4%至5%。与再梗死率显著增加相关的危险因素包括术前高血压、术中低血压发作以及持续时间超过3小时的非心脏胸部或上腹部手术。麻醉时间与整个组的再梗死率显著相关。术后入住重症监护病房对再梗死率没有显著影响，糖尿病、心绞痛、患者年龄或性别以及前次心肌梗死的部位也没有影响。
