Study: Rates of MACCE Have Declined in Patients Undergoing Noncardiac Surgery
According to a new study, rates of major adverse cardiovascular and cerebrovascular events (MACCE) have declined in patients undergoing major noncardiac surgery, but rates of ischemic stroke have risen.
Researchers used data from the National Inpatient Sample to study trends in perioperative cardiovascular events in patients who underwent major noncardiac surgery between 2004 to 2013, examining the number of in-hospital, all-caused death, acute myocardial infarction, or acute ischemic stroke. The study included 10,581,621 hospitalizations for noncardiac surgery.
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Perioperative major adverse cardiovascular events occurred in 317,479 (3%) of patients. Vascular, thoracic, and transplant surgery had the largest frequency of MACCE in patients, with 7.7% occurring in those who underwent vascular, 6.5% occurring in those who underwent thoracic, and 6.3% occurring in those who underwent transplant surgery.
The frequency of MACCE declined from 3.1% to 2.6% between 2004 to 2013. Likewise, perioperative deaths and acute myocardial infarction declined. However, perioperative ischemic stroke rose from .52% to .77% from 2004 to 2013.
Overall, 1 in 33 patients hospitalized for noncardiac surgery experiences a perioperative MACCE. The rate in acute myocardial infarction and death has declined, but the rate of perioperative ischemic strokes has increased. “Additional efforts are necessary to improve cardiovascular care in the perioperative period of patients undergoing noncardiac surgery,” the researchers concluded.
—Melissa Weiss
Reference:
Smilowitz NR, Gupta N, Ramakrishna H, et al. Perioperative major adverse cardiovascular and cerebrovascular events associated with noncardiac surgery [published online December 28, 2016]. JAMA Cardiology. doi:10.1001/jamacardio.2016.4792.