Analysis of risk factors for myocardial infarction and cardiac mortality after major vascular surgery
Patients undergoing vascular surgical procedures are at high risk for perioperative myocardial infarction (PMI). This study was undertaken to identify predictors of PMI and in-hospital death in major vascular surgical patients. From the Vascular Surgery Registry (6,948 operations from January 1989 t...
Gespeichert in:
| Veröffentlicht in: | Anesthesiology (Philadelphia) 2000-07, Vol.93 (1), p.129-140 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 140 |
|---|---|
| container_issue | 1 |
| container_start_page | 129 |
| container_title | Anesthesiology (Philadelphia) |
| container_volume | 93 |
| creator | SPRUNG, J ABDELMALAK, B GOTTLIEB, A MAYHEW, C HAMMEL, J LEVY, P. J O'HARA, P HERTZER, N. R |
| description | Patients undergoing vascular surgical procedures are at high risk for perioperative myocardial infarction (PMI). This study was undertaken to identify predictors of PMI and in-hospital death in major vascular surgical patients.
From the Vascular Surgery Registry (6,948 operations from January 1989 through June 1997) the authors identified 107 patients in whom PMI developed during the same hospital stay. Case-control patients (patients without PMI) were matched at a 1x:x1 ratio with index cases according to the type of surgery, gender, patient age, and year of surgery. The authors analyzed data regarding preoperative cardiac disease and surgical and anesthetic factors to study association with PMI and cardiac death.
By using univariable analysis the authors identified the following predictors of PMI: valvular disease (P = 0.007), previous congestive heart failure (P = 0.04), emergency surgery (P = 0.02), general anesthesia (P = 0.03), preoperative history of coronary artery disease (P = 0.001), preoperative treatment with beta-blockers (P = 0.003), lower preoperative (P = 0.03) and postoperative (P = 0.002) hemoglobin concentrations, increased bleeding rate (as assessed from increased cell salvage; P = 0.025), and lower ejection fraction (P = 0.02). Of the 107 patients with PMI, 20.6% died of cardiac cause during the same hospital stay. The following factors increased the odds ratios for cardiac death: age (P = 0.001), recent congestive heart failure (P = 0.01), type of surgery (P = 0.04), emergency surgery (P = 0.02), lower intraoperative diastolic blood pressure (P = 0.001), new intraoperative ST-T changes (P = 0.01), and increased intraoperative use of blood (P = 0.005). Patients who underwent coronary artery bypass grafting, even more than 12 months before index surgery, had a 79% reduction in risk of death if they had PMI (P = 0.01). Multivariable analysis revealed preoperative definitive diagnosis of coronary artery disease (P = 0.001) and significant valvular disease (P = 0.03) were associated with increased risk of PMI. Congestive heart failure less than 1 yr before index vascular surgery (P = 0. 0002) and increased intraoperative use of blood (P = 0.007) were associated with cardiac death. The history of coronary artery bypass grafting reduced the risk of cardiac death (P = 0.04) in patients with PMI.
The in-hospital cardiac mortality rate is high for patients who undergo vascular surgery and experience clinically significant PMI. Stress of surgery |
| doi_str_mv | 10.1097/00000542-200007000-00023 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71196130</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>71196130</sourcerecordid><originalsourceid>FETCH-LOGICAL-c485t-e95d7fda3955a494fe924dafbaa0b137f59b5af7a9ed6f20e0fbcbf9ab225cf3</originalsourceid><addsrcrecordid>eNpNkNtKxDAQhoMouh5eQXIh3lVzaNrmclk8geDN3pdpmpGsbaNJK_TtzbrrYWCYMHz_BD5CKGc3nOnylm1L5SIT20eZOkst5AFZcCWqjPNSHZJF2slMMiFOyGmMmy2qZHVMTjirCs5VsSB2OUA3RxepRxpcfKMIZvQhUvSB9rM3EFoHHXUDQjCj8wOFoaW7taG9DyN0bpwp4GhTAjYp9wnRTB0EGqfwasN8To4Qumgv9vOMrO_v1qvH7Pnl4Wm1fM5MXqkxs1q1JbYgtVKQ6xytFnkL2ACwhssSlW4UYAnatgUKZhk2pkENjRDKoDwj17uz78F_TDaOde-isV0Hg_VTrEvOdcElS2C1A03wMQaL9XtwPYS55qzeGq5_DNe_hutvwyl6uf9janrb_gvulCbgag8kCdBhgMG4-MflsshZIb8A63iGIg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>71196130</pqid></control><display><type>article</type><title>Analysis of risk factors for myocardial infarction and cardiac mortality after major vascular surgery</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Journals@Ovid Complete</source><creator>SPRUNG, J ; ABDELMALAK, B ; GOTTLIEB, A ; MAYHEW, C ; HAMMEL, J ; LEVY, P. J ; O'HARA, P ; HERTZER, N. R</creator><creatorcontrib>SPRUNG, J ; ABDELMALAK, B ; GOTTLIEB, A ; MAYHEW, C ; HAMMEL, J ; LEVY, P. J ; O'HARA, P ; HERTZER, N. R</creatorcontrib><description>Patients undergoing vascular surgical procedures are at high risk for perioperative myocardial infarction (PMI). This study was undertaken to identify predictors of PMI and in-hospital death in major vascular surgical patients.
From the Vascular Surgery Registry (6,948 operations from January 1989 through June 1997) the authors identified 107 patients in whom PMI developed during the same hospital stay. Case-control patients (patients without PMI) were matched at a 1x:x1 ratio with index cases according to the type of surgery, gender, patient age, and year of surgery. The authors analyzed data regarding preoperative cardiac disease and surgical and anesthetic factors to study association with PMI and cardiac death.
By using univariable analysis the authors identified the following predictors of PMI: valvular disease (P = 0.007), previous congestive heart failure (P = 0.04), emergency surgery (P = 0.02), general anesthesia (P = 0.03), preoperative history of coronary artery disease (P = 0.001), preoperative treatment with beta-blockers (P = 0.003), lower preoperative (P = 0.03) and postoperative (P = 0.002) hemoglobin concentrations, increased bleeding rate (as assessed from increased cell salvage; P = 0.025), and lower ejection fraction (P = 0.02). Of the 107 patients with PMI, 20.6% died of cardiac cause during the same hospital stay. The following factors increased the odds ratios for cardiac death: age (P = 0.001), recent congestive heart failure (P = 0.01), type of surgery (P = 0.04), emergency surgery (P = 0.02), lower intraoperative diastolic blood pressure (P = 0.001), new intraoperative ST-T changes (P = 0.01), and increased intraoperative use of blood (P = 0.005). Patients who underwent coronary artery bypass grafting, even more than 12 months before index surgery, had a 79% reduction in risk of death if they had PMI (P = 0.01). Multivariable analysis revealed preoperative definitive diagnosis of coronary artery disease (P = 0.001) and significant valvular disease (P = 0.03) were associated with increased risk of PMI. Congestive heart failure less than 1 yr before index vascular surgery (P = 0. 0002) and increased intraoperative use of blood (P = 0.007) were associated with cardiac death. The history of coronary artery bypass grafting reduced the risk of cardiac death (P = 0.04) in patients with PMI.
The in-hospital cardiac mortality rate is high for patients who undergo vascular surgery and experience clinically significant PMI. Stress of surgery (increased intraoperative bleeding and aortic, peripheral vascular, and emergency surgery), poor preoperative cardiac functional status (congestive heart failure, lower ejection fraction, diagnosis of coronary artery disease), and preoperative history of coronary artery bypass grafting are the factors that determine perioperative cardiac morbidity and mortality rates.</description><identifier>ISSN: 0003-3022</identifier><identifier>EISSN: 1528-1175</identifier><identifier>DOI: 10.1097/00000542-200007000-00023</identifier><identifier>PMID: 10861156</identifier><identifier>CODEN: ANESAV</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Analysis of Variance ; Anesthesia ; Anesthesia depending on type of surgery ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Case-Control Studies ; Electrocardiography ; Heart Diseases - complications ; Heart Diseases - mortality ; Hemodynamics ; Hospital Mortality ; Humans ; Incidence ; Intraoperative Complications - etiology ; Intraoperative Complications - mortality ; Logistic Models ; Medical sciences ; Myocardial Infarction - diagnosis ; Myocardial Infarction - etiology ; Myocardial Infarction - mortality ; Ohio ; Postoperative Complications - etiology ; Postoperative Complications - mortality ; Registries ; Risk Factors ; Thoracic and cardiovascular surgery. Cardiopulmonary bypass ; Vascular Diseases - surgery</subject><ispartof>Anesthesiology (Philadelphia), 2000-07, Vol.93 (1), p.129-140</ispartof><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c485t-e95d7fda3955a494fe924dafbaa0b137f59b5af7a9ed6f20e0fbcbf9ab225cf3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27907,27908</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1436406$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10861156$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SPRUNG, J</creatorcontrib><creatorcontrib>ABDELMALAK, B</creatorcontrib><creatorcontrib>GOTTLIEB, A</creatorcontrib><creatorcontrib>MAYHEW, C</creatorcontrib><creatorcontrib>HAMMEL, J</creatorcontrib><creatorcontrib>LEVY, P. J</creatorcontrib><creatorcontrib>O'HARA, P</creatorcontrib><creatorcontrib>HERTZER, N. R</creatorcontrib><title>Analysis of risk factors for myocardial infarction and cardiac mortality after major vascular surgery</title><title>Anesthesiology (Philadelphia)</title><addtitle>Anesthesiology</addtitle><description>Patients undergoing vascular surgical procedures are at high risk for perioperative myocardial infarction (PMI). This study was undertaken to identify predictors of PMI and in-hospital death in major vascular surgical patients.
From the Vascular Surgery Registry (6,948 operations from January 1989 through June 1997) the authors identified 107 patients in whom PMI developed during the same hospital stay. Case-control patients (patients without PMI) were matched at a 1x:x1 ratio with index cases according to the type of surgery, gender, patient age, and year of surgery. The authors analyzed data regarding preoperative cardiac disease and surgical and anesthetic factors to study association with PMI and cardiac death.
By using univariable analysis the authors identified the following predictors of PMI: valvular disease (P = 0.007), previous congestive heart failure (P = 0.04), emergency surgery (P = 0.02), general anesthesia (P = 0.03), preoperative history of coronary artery disease (P = 0.001), preoperative treatment with beta-blockers (P = 0.003), lower preoperative (P = 0.03) and postoperative (P = 0.002) hemoglobin concentrations, increased bleeding rate (as assessed from increased cell salvage; P = 0.025), and lower ejection fraction (P = 0.02). Of the 107 patients with PMI, 20.6% died of cardiac cause during the same hospital stay. The following factors increased the odds ratios for cardiac death: age (P = 0.001), recent congestive heart failure (P = 0.01), type of surgery (P = 0.04), emergency surgery (P = 0.02), lower intraoperative diastolic blood pressure (P = 0.001), new intraoperative ST-T changes (P = 0.01), and increased intraoperative use of blood (P = 0.005). Patients who underwent coronary artery bypass grafting, even more than 12 months before index surgery, had a 79% reduction in risk of death if they had PMI (P = 0.01). Multivariable analysis revealed preoperative definitive diagnosis of coronary artery disease (P = 0.001) and significant valvular disease (P = 0.03) were associated with increased risk of PMI. Congestive heart failure less than 1 yr before index vascular surgery (P = 0. 0002) and increased intraoperative use of blood (P = 0.007) were associated with cardiac death. The history of coronary artery bypass grafting reduced the risk of cardiac death (P = 0.04) in patients with PMI.
The in-hospital cardiac mortality rate is high for patients who undergo vascular surgery and experience clinically significant PMI. Stress of surgery (increased intraoperative bleeding and aortic, peripheral vascular, and emergency surgery), poor preoperative cardiac functional status (congestive heart failure, lower ejection fraction, diagnosis of coronary artery disease), and preoperative history of coronary artery bypass grafting are the factors that determine perioperative cardiac morbidity and mortality rates.</description><subject>Analysis of Variance</subject><subject>Anesthesia</subject><subject>Anesthesia depending on type of surgery</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>Electrocardiography</subject><subject>Heart Diseases - complications</subject><subject>Heart Diseases - mortality</subject><subject>Hemodynamics</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Incidence</subject><subject>Intraoperative Complications - etiology</subject><subject>Intraoperative Complications - mortality</subject><subject>Logistic Models</subject><subject>Medical sciences</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - etiology</subject><subject>Myocardial Infarction - mortality</subject><subject>Ohio</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - mortality</subject><subject>Registries</subject><subject>Risk Factors</subject><subject>Thoracic and cardiovascular surgery. Cardiopulmonary bypass</subject><subject>Vascular Diseases - surgery</subject><issn>0003-3022</issn><issn>1528-1175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkNtKxDAQhoMouh5eQXIh3lVzaNrmclk8geDN3pdpmpGsbaNJK_TtzbrrYWCYMHz_BD5CKGc3nOnylm1L5SIT20eZOkst5AFZcCWqjPNSHZJF2slMMiFOyGmMmy2qZHVMTjirCs5VsSB2OUA3RxepRxpcfKMIZvQhUvSB9rM3EFoHHXUDQjCj8wOFoaW7taG9DyN0bpwp4GhTAjYp9wnRTB0EGqfwasN8To4Qumgv9vOMrO_v1qvH7Pnl4Wm1fM5MXqkxs1q1JbYgtVKQ6xytFnkL2ACwhssSlW4UYAnatgUKZhk2pkENjRDKoDwj17uz78F_TDaOde-isV0Hg_VTrEvOdcElS2C1A03wMQaL9XtwPYS55qzeGq5_DNe_hutvwyl6uf9janrb_gvulCbgag8kCdBhgMG4-MflsshZIb8A63iGIg</recordid><startdate>20000701</startdate><enddate>20000701</enddate><creator>SPRUNG, J</creator><creator>ABDELMALAK, B</creator><creator>GOTTLIEB, A</creator><creator>MAYHEW, C</creator><creator>HAMMEL, J</creator><creator>LEVY, P. J</creator><creator>O'HARA, P</creator><creator>HERTZER, N. R</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000701</creationdate><title>Analysis of risk factors for myocardial infarction and cardiac mortality after major vascular surgery</title><author>SPRUNG, J ; ABDELMALAK, B ; GOTTLIEB, A ; MAYHEW, C ; HAMMEL, J ; LEVY, P. J ; O'HARA, P ; HERTZER, N. R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c485t-e95d7fda3955a494fe924dafbaa0b137f59b5af7a9ed6f20e0fbcbf9ab225cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Analysis of Variance</topic><topic>Anesthesia</topic><topic>Anesthesia depending on type of surgery</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Case-Control Studies</topic><topic>Electrocardiography</topic><topic>Heart Diseases - complications</topic><topic>Heart Diseases - mortality</topic><topic>Hemodynamics</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Incidence</topic><topic>Intraoperative Complications - etiology</topic><topic>Intraoperative Complications - mortality</topic><topic>Logistic Models</topic><topic>Medical sciences</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Infarction - etiology</topic><topic>Myocardial Infarction - mortality</topic><topic>Ohio</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - mortality</topic><topic>Registries</topic><topic>Risk Factors</topic><topic>Thoracic and cardiovascular surgery. Cardiopulmonary bypass</topic><topic>Vascular Diseases - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SPRUNG, J</creatorcontrib><creatorcontrib>ABDELMALAK, B</creatorcontrib><creatorcontrib>GOTTLIEB, A</creatorcontrib><creatorcontrib>MAYHEW, C</creatorcontrib><creatorcontrib>HAMMEL, J</creatorcontrib><creatorcontrib>LEVY, P. J</creatorcontrib><creatorcontrib>O'HARA, P</creatorcontrib><creatorcontrib>HERTZER, N. R</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Anesthesiology (Philadelphia)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SPRUNG, J</au><au>ABDELMALAK, B</au><au>GOTTLIEB, A</au><au>MAYHEW, C</au><au>HAMMEL, J</au><au>LEVY, P. J</au><au>O'HARA, P</au><au>HERTZER, N. R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analysis of risk factors for myocardial infarction and cardiac mortality after major vascular surgery</atitle><jtitle>Anesthesiology (Philadelphia)</jtitle><addtitle>Anesthesiology</addtitle><date>2000-07-01</date><risdate>2000</risdate><volume>93</volume><issue>1</issue><spage>129</spage><epage>140</epage><pages>129-140</pages><issn>0003-3022</issn><eissn>1528-1175</eissn><coden>ANESAV</coden><abstract>Patients undergoing vascular surgical procedures are at high risk for perioperative myocardial infarction (PMI). This study was undertaken to identify predictors of PMI and in-hospital death in major vascular surgical patients.
From the Vascular Surgery Registry (6,948 operations from January 1989 through June 1997) the authors identified 107 patients in whom PMI developed during the same hospital stay. Case-control patients (patients without PMI) were matched at a 1x:x1 ratio with index cases according to the type of surgery, gender, patient age, and year of surgery. The authors analyzed data regarding preoperative cardiac disease and surgical and anesthetic factors to study association with PMI and cardiac death.
By using univariable analysis the authors identified the following predictors of PMI: valvular disease (P = 0.007), previous congestive heart failure (P = 0.04), emergency surgery (P = 0.02), general anesthesia (P = 0.03), preoperative history of coronary artery disease (P = 0.001), preoperative treatment with beta-blockers (P = 0.003), lower preoperative (P = 0.03) and postoperative (P = 0.002) hemoglobin concentrations, increased bleeding rate (as assessed from increased cell salvage; P = 0.025), and lower ejection fraction (P = 0.02). Of the 107 patients with PMI, 20.6% died of cardiac cause during the same hospital stay. The following factors increased the odds ratios for cardiac death: age (P = 0.001), recent congestive heart failure (P = 0.01), type of surgery (P = 0.04), emergency surgery (P = 0.02), lower intraoperative diastolic blood pressure (P = 0.001), new intraoperative ST-T changes (P = 0.01), and increased intraoperative use of blood (P = 0.005). Patients who underwent coronary artery bypass grafting, even more than 12 months before index surgery, had a 79% reduction in risk of death if they had PMI (P = 0.01). Multivariable analysis revealed preoperative definitive diagnosis of coronary artery disease (P = 0.001) and significant valvular disease (P = 0.03) were associated with increased risk of PMI. Congestive heart failure less than 1 yr before index vascular surgery (P = 0. 0002) and increased intraoperative use of blood (P = 0.007) were associated with cardiac death. The history of coronary artery bypass grafting reduced the risk of cardiac death (P = 0.04) in patients with PMI.
The in-hospital cardiac mortality rate is high for patients who undergo vascular surgery and experience clinically significant PMI. Stress of surgery (increased intraoperative bleeding and aortic, peripheral vascular, and emergency surgery), poor preoperative cardiac functional status (congestive heart failure, lower ejection fraction, diagnosis of coronary artery disease), and preoperative history of coronary artery bypass grafting are the factors that determine perioperative cardiac morbidity and mortality rates.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>10861156</pmid><doi>10.1097/00000542-200007000-00023</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0003-3022 |
| ispartof | Anesthesiology (Philadelphia), 2000-07, Vol.93 (1), p.129-140 |
| issn | 0003-3022 1528-1175 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_71196130 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Journals@Ovid Complete |
| subjects | Analysis of Variance Anesthesia Anesthesia depending on type of surgery Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Case-Control Studies Electrocardiography Heart Diseases - complications Heart Diseases - mortality Hemodynamics Hospital Mortality Humans Incidence Intraoperative Complications - etiology Intraoperative Complications - mortality Logistic Models Medical sciences Myocardial Infarction - diagnosis Myocardial Infarction - etiology Myocardial Infarction - mortality Ohio Postoperative Complications - etiology Postoperative Complications - mortality Registries Risk Factors Thoracic and cardiovascular surgery. Cardiopulmonary bypass Vascular Diseases - surgery |
| title | Analysis of risk factors for myocardial infarction and cardiac mortality after major vascular surgery |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-16T07%3A46%3A07IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Analysis%20of%20risk%20factors%20for%20myocardial%20infarction%20and%20cardiac%20mortality%20after%20major%20vascular%20surgery&rft.jtitle=Anesthesiology%20(Philadelphia)&rft.au=SPRUNG,%20J&rft.date=2000-07-01&rft.volume=93&rft.issue=1&rft.spage=129&rft.epage=140&rft.pages=129-140&rft.issn=0003-3022&rft.eissn=1528-1175&rft.coden=ANESAV&rft_id=info:doi/10.1097/00000542-200007000-00023&rft_dat=%3Cproquest_cross%3E71196130%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=71196130&rft_id=info:pmid/10861156&rfr_iscdi=true |