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Postoperative troponin

Khola Tahir, Eric Pauley, Xuming Dai, Sidney C Smith, Craig Sweeney, George A Stouffer
ST elevation myocardial infarction (STEMI) occurring in patients hospitalized for a noncardiac condition is associated with a high mortality rate and thus we sought to determine the mechanisms underlying STEMI in this patient population. This is a single center retrospective study of 70 patients who had STEMI while hospitalized on a noncardiac service and underwent coronary angiography. Thrombotic in-hospital STEMI was defined by angiographic or intravascular imaging evidence of intracoronary thrombus, plaque rupture, or stent thrombosis...
February 7, 2019: American Journal of Cardiology
Arthelma C Tyson, Shailraj Parikh, Kuldeep Singh, Saqib Zia, Jonathan S Deitch, Jonathan A Schor
BACKGROUND: Routine laboratory testing to rule out myocardial infarction (MI) after carotid endarterectomy (CEA) is common in many centers. Its utility in this patient population has not been thoroughly investigated. We hypothesize that routine testing for MI in post-CEA patients is of low-yield and not cost-effective. METHODS: A retrospective review of 291 consecutive CEAs from February, 2011 to July, 2015 was performed. Two patients were excluded: one for postoperative non-cardiac death and one for preoperative MI...
February 12, 2019: Annals of Vascular Surgery
Shuo-Fang Ren, Hong Yu, Ying-Qiang Guo, Hai Yu
INTRODUCTION: Many studies have found that volatile anesthetics are associated with improved clinical outcomes for adults undergoing coronary artery bypass grafting. However, the effect of volatile anesthetics for adults after heart valve surgery has been unclear. So we conducted a meta-analysis of randomized controlled trials (RCTs) to explore whether the choice of an anesthetic regimen might influence patients' outcomes after valve surgery. EVIDENCE ACQUISITION: PubMed, Embase, and Cochrane Library were searched from inception to June 2018...
February 13, 2019: Minerva Anestesiologica
Mustafa Cagdas Cayir, Ahmet Yuksel
BACKGROUND: The del Nido (DN) cardioplegia solution has been widely used in paediatric open-heart surgery for years; however, its application in adult open-heart surgery has not yet gained sufficient popularity. We investigated the safety and efficiency of the DN cardioplegia solution versus the traditional crystalloid cardioplegia solution [St. Thomas' Hospital (STH) cardioplegia solution] in adult patients undergoing coronary artery bypass grafting (CABG). METHODS: A retrospective comparative analysis of 200 consecutive patients undergoing isolated on-pump CABG between April 2016 and September 2017 was performed...
January 18, 2019: Heart, Lung & Circulation
Mir Mohammad Taghi Mortazavi, Jafar Ganjpour Sales, Masoud Nouri-Vaskeh, Masoud Parish, Salar Abdolhosseynzadeh
Background: Cardiac injury is one of the significant perioperative complications in major orthopedic surgeries and its early diagnosis is useful in the reduction of postoperative comorbidity. The cardiac troponin is a sensitive and specific biomarker for detecting this damage. Objectives: The aim of this study was to evaluate the levels of perioperative cardiac troponin I (cTnI) before and after arthroplasty in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA)...
December 2018: Anesthesiology and Pain Medicine
Yanqi Wu, Yahui Wang, Feng Shen, Bo Liu, Hong Qian, Huiling Yang, Yumei Cheng, Guixia Yang, Xiang Li, Xinghao Zheng
OBJECTIVE: To compare the influence of sevoflurane inhalation sedation and propofol intravenous sedation on duration of endotracheal intubation as well as the length of intensive care unit (ICU) stay and total length of hospital stay in postoperative critical patients. METHODS: Six databases including CNKI, Wanfang data, PubMed, Embase, Cochrane Library and Web of Science were searched for randomized controlled trials (RCTs) about the influence of sevoflurane inhalation sedation or propofol intravenous sedation on the sedation time, the duration of endotracheal intubation, the length of ICU stay, the total length of hospital stay and the adverse effects rate in postoperative critical patients from the time of database establishment to July 2018...
January 2019: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Y Y Jin, R Bai, M Ye, H Ai, Y J Zeng, S P Nie
Objective: To explore the risk factors and prognoses of new-onset atrial fibrillation (NOAF) in patients with acute myocardial infarction (AMI). Methods: A total of 468 patients with AMI were admitted into Beijing Anzhen Hospital for emergency pereutaneous coronary intervention (PCI). According to the NOAF occurred during hospitalization, the patients were divided into two groups: the NOAF ( n= 37) group and the non-NOAF ( n= 431) group. Parameters including general clinical conditions, coronary lesions, echocardiography, biochemical markers, C-reactive protein (CRP) , N-terminal pro-brain natriuretic peptide (NT-pro-BNP), and myocardial markers were collected...
February 1, 2019: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
L V Kremneva, O V Abaturova, A Y Efanov, S V Shalaev
AIM: Evaluate the frequency and risk factors of postoperative atrial fibrillation (pAF) in patients with chronic coronary artery disease (CHD) with acute kidney injury (AKI) developed in connection with coronary artery bypass grafting (CABG). MATERIALS AND METHODS: The study involved 90 patients (pts) undergoing CABG at age 58±7 years, duration of CHD - 6±6 years. 80% of pts had previous myocardial infarction. Chronic heart failure, functional class II was detected in 53...
June 20, 2018: Terapevticheskiĭ Arkhiv
Piotr Duchnowski, Tomasz Hryniewiecki, Mariusz Kuśmierczyk, Piotr Szymański
BACKGROUND: The usefulness of high-sensitivity troponin T (hs-TnT) as a predictor of sudden cardiac arrest (SCA) in patients undergoing valve surgery is currently unknown. METHODS: A prospective study was conducted on a group of 815 consecutive patients with significant valvular heart disease that underwent elective valve surgery. The primary end-point was postoperative SCA. RESULTS: The postoperative SCA occurred in 26 patients. At multivariate analysis of hs-TnT measured immediately after surgery (hs-TnT I) and age remained independent predictors of the primary end-point...
January 31, 2019: Cardiology Journal
T E F Abbott, R M Pearse, B H Cuthbertson, D N Wijeysundera, G L Ackland
BACKGROUND: The aetiology of perioperative myocardial injury is poorly understood and not clearly linked to pre-existing cardiovascular disease. We hypothesised that loss of cardioprotective vagal tone [defined by impaired heart rate recovery ≤12 beats min-1 (HRR ≤12) 1 min after cessation of preoperative cardiopulmonary exercise testing] was associated with perioperative myocardial injury. METHODS: We conducted a pre-defined, secondary analysis of a multi-centre prospective cohort study of preoperative cardiopulmonary exercise testing...
February 2019: British Journal of Anaesthesia
G L Ackland, T E F Abbott, D Cain, M R Edwards, P Sultan, S N Karmali, A J Fowler, J R Whittle, N J MacDonald, A Reyes, L Gallego Paredes, R C M Stephens, A Gutierrez Del Arroyo, S Woldman, R A Archbold, A Wragg, E Kam, T Ahmad, A W Khan, E Niebrzegowska, R M Pearse
BACKGROUND: Systemic inflammation is pivotal in the pathogenesis of cardiovascular disease. As inflammation can directly cause cardiomyocyte injury, we hypothesised that established systemic inflammation, as reflected by elevated preoperative neutrophil-lymphocyte ratio (NLR) >4, predisposes patients to perioperative myocardial injury. METHODS: We prospectively recruited 1652 patients aged ≥45 yr who underwent non-cardiac surgery in two UK centres. Serum high sensitivity troponin T (hsTnT) concentrations were measured on the first three postoperative days...
February 2019: British Journal of Anaesthesia
Yunbin Xu, Yong Li, Weiguo Bao, Shi Qiu
OBJECTIVE: To investigate the clinical significance of minimally invasive direct coronary artery bypass (MIDCAB). METHODS: 300 patients admitted to the Second Hosptial of Shandong University Hospital from March 2006 to February 2010 were retrospectively analyzed and received off-pump operation under general anesthesia. According to surgical methods, patients were divided into the MIDCAB group (n=90) and the median sternotomy off-pump coronary artery bypass (OPCAB) group, namely the OPCAB group (n=210)...
January 24, 2019: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Zuojing Zhang, Meiying Xu, Dehua Wu, Xiaofeng Zhang, Jingxiang Wu
BACKGROUND: Risk of intraoperative hypothermia is relatively high in middle-aged and elderly patients undergoing curative resection of esophageal cancer, which may cause myocardial ischemia during the early postoperative period. The objective of this study was to compare aggressive or standard body temperature management for lowering the incidence of postoperative myocardial injury that was assessed by troponin levels collected at a priori defined set times in these patients. METHODS: Seventy patients undergoing elective curative resection of esophageal cancer were randomly assigned to undergo aggressive body temperature management (nasopharyngeal temperature ≥36°C) or standard body temperature management (n = 35 in each arm)...
January 21, 2019: Anesthesia and Analgesia
K H J M Mol, S E Hoeks, V G B Liem, R J Stolker, F van Lier
INTRODUCTION: Troponin elevations after intermediate-to-high risk noncardiac surgery are common and can predict mortality. However, the prognostic value for early and late major adverse cardiovascular events (MACE) is less well investigated. The authors evaluated the relationship between postoperative troponin release and MACE in the first year after noncardiac surgery. METHODS: This observational cohort registry comprised data of patients aged ≥60 years undergoing intermediate-to-high risk noncardiac surgery between July 2012 and 2015, at the Erasmus University Medical Center, Rotterdam, the Netherlands...
January 10, 2019: International Journal of Cardiology
Jean-Sebastien Lebon, Pierre Couture, Melissa Colizza, Annik Fortier, Antoine Rochon, Christian Ayoub, Georges Desjardins, Alain Deschamps, Marie-Ève Chamberland, Eric Laliberté, Denis Bouchard, Michel Pellerin
OBJECTIVE: To compare myocardial protection with retrograde cardioplegia alone with antegrade and retrograde cardioplegia in minimally invasive mitral valve surgery (MIMS). DESIGN: Retrospective study. SETTING: Tertiary care university hospital. PARTICIPANTS: The authors studied 97 MIMS patients using retrograde cardioplegia alone and 118 MIMS patients using antegrade and retrograde cardioplegia. INTERVENTIONS: The data from patients admitted for MIMS using retrograde cardioplegia (MIMS retro) between 2009 to 2012 were compared with the data from patients undergoing MIMS with antegrade and retrograde cardioplegia (MIMS ante-retro) between 2006 and 2010 (control group)...
November 28, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Rafael Diniz Abrantes, Alexandre Ciappina Hueb, Whady Hueb, Fabio B Jatene
OBJECTIVE: To analyze the inflammation resulting from myocardial revascularization techniques with and without cardiopulmonary bypass, based on ultrasensitive C-reactive protein (US-CRP) behavior. METHODS: A prospective non-randomized clinical study with 136 patients was performed. Sixty-nine patients were enrolled for Group 1 (on-pump coronary artery bypass - ONCAB) and 67 patients were assigned to Group 2 (off-pump coronary artery bypass - OPCAB). All study participants had blood samples collected for analysis of glucose, triglycerides, creatinine, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and creatinephosphokinase (CPK) in the preoperative period...
November 2018: Brazilian Journal of Cardiovascular Surgery
Marek A Deja, Magda Piekarska, Marcin Malinowski, Ryszard Wiaderkiewicz, Piotr Czekaj, Leszek Machej, Andrzej Weglarzy, Adam Kowalówka, Tadeusz Kolodziej, Ewa Czech, Danuta Plewka, Magdalena Mizia, Tomasz Latusek, Bartosz Szurlej
OBJECTIVES: No experimental study has shown that the myocardium of a remotely preconditioned patient is more resistant to a standardized ischaemic/hypoxic insult. METHODS: This was a single-centre randomized (1:1), double-blinded, sham-controlled, parallel-group study. Patients referred for elective coronary bypass surgery were allocated to either remote ischaemic preconditioning (3 cycles of 5-min ischaemia/5-min reperfusion of the right arm using a blood pressure cuff inflated to 200 mmHg) or sham intervention...
January 10, 2019: European Journal of Cardio-thoracic Surgery
Rakesh V Reddy, Sanjay Agarwal, Vinod Choudhary, Amit K Singhal
A 39-year-old female patient with hepatitis B-related decompensated chronic liver disease underwent living donor liver transplantation. Preoperatively, she had a normal electrocardiogram (ECG) and echocardiography, and also a negative dobutamine stress echocardiography test. Intraoperative course went uneventful. Two hours postoperatively, she developed hypotension. Initially, hypotension was treated with fluids and blood products after confirming normal echocardiography, but with time, patient's haemodynamics worsened...
December 2018: Indian Journal of Anaesthesia
Shannon M Ruzycki, Rahim Kachra, Kristin Lyons
No abstract text is available yet for this article.
January 7, 2019: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Pietro Giorgio Malvindi, Vito Margari, Florinda Mastro, Giuseppe Visicchio, Georgios Kounakis, Antonella Favale, Pierpaolo Dambruoso, Cataldo Labriola, Carmine Carbone, Domenico Paparella
Background: Minimally invasive cardiac surgery has increasingly been used for patients with valvular pathology. Two techniques of aortic occlusion are utilized with this technique: transthoracic aortic clamp (TTC) and endoaortic balloon occlusion (EAO). Both possibilities present peculiar advantages and limitations whose current evidence is based on few observational studies. We performed an analysis with the primary objective to evaluate outcomes and the incidence of major complications of these two techniques...
November 2018: Annals of Cardiothoracic Surgery
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