Myocardial infarction after esophagectomy for esophageal cancer: A systematic review

Background Esophagectomy remains the most effective treatment modality for esophageal cancer. However, esophagectomy is associated with several postoperative complications, including anastomotic leak, new-onset atrial fibrillation, pneumonia, venous thromboembolism events, and myocardial infarction. In this systematic review of the literature, we aim to assess the incidence of myocardial infarction in patients with esophageal cancer undergoing esophagectomy and to identify possible risk factors for myocardial infarction. Methods A systematic search of the English-language medical literature was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (end of search: September 30, 2020). Results A total of 14 studies met our inclusion criteria for the current review. Overall, 3673 patients who underwent esophagectomy were identified. Among them, 70 (1.9%) developed myocardial infarction postoperatively. The following risk factors were reported in the individual studies: age, previous myocardial infarction, ventricular arrythmia, smoking, chronic obstructive pulmonary disease, diabetes mellitus, thromboembolic disease, hypertension, and heart failure. Conclusion Myocardial infarction remains an important complication after esophageal surgery. Further investigations are needed to better understand the risk factors and optimum management for post-esophagectomy myocardial infarction.