Influence of ageing on perioperative cardiac risk in non-cardiac surgery.

BACKGROUND ageing is known to augment perioperative cardiac risk in non-cardiac surgery. However, it remains unclear whether the increased risk is attributable to ageing itself or to the associated cardiac risk factors and coronary artery disease. METHODS this retrospective study enrolled 1,351 patients who underwent non-cardiac surgery after dipyridamole stress myocardial perfusion scintigraphy. These patients were divided into the following four groups: Group 1-E (aged 75 or more, normal single photon emission computed tomography (SPECT)), Group 1-Y (aged less than 75, normal SPECT), Group 2-E (aged 75 or more, abnormal SPECT) and Group 2-Y (aged less than 75, abnormal SPECT). Clinical risk factors, scintigraphic findings and occurrence of perioperative cardiac events were analysed. RESULTS the older cohorts had a significantly higher number of risk factors than their younger counterparts. No significant difference was observed in the degree of perfusion abnormality between Groups 2-E and 2-Y. Although the event rates were comparable in Groups 1-E and 1-Y, Group 2-E yielded a significantly higher rate than Group 2-Y. Ageing was an independent predictor of cardiac events in Group 2 in multivariate analysis. CONCLUSIONS ageing has no influence on perioperative cardiac risk in patients without overt myocardial infarction or ischaemia. The likelihood of cardiac events is increased by ageing, independently of other variables, in patients with perfusion abnormality.