Perioperative medicine & outcomes
Time Since Prior NSTEMI and Major Adverse Cardiovascular and Cerebrovascular Events After Noncardiac Surgery
Authors' conclusion
This study found that among older patients undergoing noncardiac surgery who had revascularization, the odds of postoperative MACCE and mortality leveled off between 30 and 90 days and then increased after 180 days. The odds did not level off for patients who did not have revascularization.
Study context
- Population
- Medicare patients 67 years or older undergoing major noncardiac surgery, 2015–2020
- Participants
- 5,227,473 surgeries
- Exposure
- Time since prior NSTEMI vs no prior NSTEMI
- Prior NSTEMIn = 42,278
- Outcome
- MACCE (30-day mortality, in-hospital MI, HF, or stroke) and all-cause 30-day mortality
Methodological detailsMedicare claims data, multivariable logistic regression
- Medicare claims data
- Multivariable logistic regression
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Major adverse cardiovascular and cerebrovascular events (MACCE) >180 days after NSTEMI (by revascularization) · 181-365 days
| aOR (95% CI) | P value | ||
|---|---|---|---|
| Any revascularization at 181-365 days | 1.46 (1.25–1.71) | P < 0.001 | |
| Drug-eluting stents at 181-365 days | 1.73 (1.42–2.12) | P < 0.001 | |
| 0.512Adjusted odds ratio (log scale) |
All-cause 30-day mortality, prior NSTEMI with revascularization
| aOR (95% CI) | P value | ||
|---|---|---|---|
| Elective 30-day | 2.88 (1.30–6.36) | P = 0.009 | |
| Elective 61- to 90-day | 1.03 (0.57–1.86) | P = 0.92 | |
| Nonelective 30-day | 1.91 (1.52–2.40) | P < 0.001 | |
| Nonelective 91- to 120-day | 1.00 (0.73–1.37) | P = 0.99 | |
| 0.10.31310Adjusted odds ratio (log scale) |
MACCE >180 days after NSTEMI (by revascularization) · 181-365 days
- Odds of MACCE leveled off after 30 days with any revascularization (after 90 days with drug-eluting stents), then increased after 180 days
- Odds of MACCE did not level off without revascularization
All-cause 30-day mortality, prior NSTEMI with revascularization
- Mortality odds leveled off after 60 days (elective) and 90 days (nonelective) with revascularization
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →