Proposed mechanisms of perioperative MI

1
Proposed mechanisms of perioperative MI
Inflammation
Hypercoagulablestate
Stress
Hypoxia
?TNF-a ?IL-1 ?IL-6 ?CRP
?PAI-1 ?Factor VIII ?Platelet reactivity ?Antithro
mbin III
?Catecholamine and cortisol levels
?Oxygen delivery
Coronary artery shear stress
?BP ?HR ?FFAs ?Relative insulin deficiency
Plaque fissuring
Plaque fissuring
?Oxygen demand
Myocardial ischemia
Acute coronary thrombosis
Perioperative myocardial infarction
Devereaux PJ et al. CMAJ. 2005173627-34.