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01-05-2014 | Original Article

Clinical Impact of Perioperative Myocardial Infarction After Pancreatic Surgery

Authors: Dmitriy I. Dovzhanskiy, Thilo Hackert, Jens Krumm, Ulf Hinz, Jens Roggenbach, Stefan Hofer, Markus W. Büchler, Jens Werner

Published in: Journal of Gastrointestinal Surgery | Issue 5/2014

Abstract

Background

The aim of this study was to evaluate the incidence, clinical impact and outcome of perioperative myocardial infarction (PMI) in patients undergoing pancreatic surgery.

Methods

A data of 1,625 patients undergoing pancreatic resection were prospectively collected and analysed with regard to PMI. Demographic aspects, co-morbidities and clinical course were evaluated. Cardiac risk factors (ASA and NYHA), postoperative complications and mortality were compared in a match-pair analysis (1:3) with patients without PMI.

Results

Twenty-nine patients with PMI after pancreatic surgery were identified. PMI occurred after all types of pancreatic operations and was observed most frequently (72.2 %) within the first postoperative week. In a total of 90 %, PMI fulfilled the criteria of non-STEMI. Nearly half of the patients (48 %) were clinically asymptomatic. Both ASA III and heart failure were more frequent in patients with PMI. The in-hospital mortality was significantly increased after PMI (p < 0.002), with post-pancreatectomy haemorrhage (PPH) as the most relevant underlying risk factor.

Conclusion

PMI is a rare but severe complication after pancreatic operations, contributing significantly to in-hospital mortality. Clinical management mainly includes an anti-coagulant approach. This may be related with an increased risk for PPH. Therefore, the use of anti-coagulant drugs in the early postoperative period—especially in asymptomatic patients—should be critically evaluated.

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Title: Clinical Impact of Perioperative Myocardial Infarction After Pancreatic Surgery
Authors: Dmitriy I. Dovzhanskiy
Thilo Hackert
Jens Krumm
Ulf Hinz
Jens Roggenbach
Stefan Hofer
Markus W. Büchler
Jens Werner
Publication date: 01-05-2014
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 5/2014
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-014-2453-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical Impact of Perioperative Myocardial Infarction After Pancreatic Surgery

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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