Table 9

Predictive Value of Preoperative ST-Segment Changes Detected by Ambulatory Monitoring for Perioperative Myocardial Infarction and Cardiac Death After Major Vascular Surgery

AuthornPatients With Abnormal Test, %Criteria for Abnormal TestPerioperative Events, % (n/N)Comments
Positive Predictive ValueNegative Predictive Value
Raby et al., 1989 (274)17618A10% (3/32)1% (1/144)24 to 48 h during ambulation
Pasternack et al., 1989 (275)20039A9% (7/78)2% (2/122)
Mangano et al., 1990 (42)14418A, B4% (1/26)4% (5/118)Immediately before surgery
Fleisher and Barash, 1992 (150)6724A, B13% (2/16)4% (2/51)Immediately before surgery
McPhail et al., 1993 (273)10034A15% (5/34)6% (4/66)
Kirwin et al., 1993 (272)969A11% (1/9)16% (14/87)Definition of MI based on enzymes only
Fleisher et al., 1995 (276)8623A, B10% (2/20)3% (2/66)Quantitative monitoring not predictive

A indicates greater than or equal to 1 mm of ST-segment depression; B, greater than or equal to 2 mm of ST-segment elevation; MI, myocardial infarction; n, number of patients; and N, total number of patients.

  • Positive predictive value for postoperative cardiac events.