Incidence of perioperative myocardial ischemia in TURP patients.

STUDY OBJECTIVE

To determine the incidence of new episodes of myocardial ischemia in patients undergoing transurethral resection of the prostate (TURP).

DESIGN

Prospective, nonrandomized study.

SETTING

Veterans Administration medical center.

PATIENTS

39 patients undergoing elective TURP.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Myocardial ischemia was detected with a 3-channel ambulatory ECG recorded. The ambulatory ECG recorder was applied preoperatively and removed when the patient left the recovery room. New myocardial ischemia was defined as a 1 mm or greater ST depression or a 2 mm or greater ST elevation from baseline, lasting for 1 minute or longer in at least one lead at the J point plus 60 msec unless this point fell within the T wave, in which case the J point 40 msec or greater was used. ST changes consistent with myocardial ischemia were confirmed by a cardiologist blinded to the patient's clinical course. Seven of 39 TURP patients (18%) had ST segment changes indicative of new myocardial ischemia. These seven patients had more prostate tissue resected and more blood loss than the 32 patients who did not have any myocardial ischemia (p < 0.05).

CONCLUSIONS

Patients undergoing TURP have an 18% incidence of myocardial ischemia. Patients undergoing TURP with more prostate tissue resected and greater blood loss are at increased risk for perioperative myocardial ischemia.