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JOURNAL ARTICLE
Yusuke Yoshikawa, Makishi Maeda, Tatsuya Kunigo, Tomoe Sato, Kanako Takahashi, Sho Ohno, Tomoki Hirahata, Michiaki Yamakage
STUDY OBJECTIVE: It remains unclear whether it is the hypotension prediction index itself or goal-directed haemodynamic therapy that mitigates intraoperative hypotension. DESIGN: A single centre randomised controlled trial. SETTING: Sapporo Medical University Hospital. PATIENTS: A total of 64 adults patients undergoing major non-cardiac surgery under general anaesthesia. INTERVENTIONS: Patients were randomly assigned to either group receiving conventional goal-directed therapy (FloTrac group) or combination of the hypotension prediction index and conventional goal-directed therapy (HPI group)...
November 30, 2023: Journal of Clinical Anesthesia
#22
REVIEW
Juliana Pereira-Macedo, Ana Filipa Silva, Luís Duarte-Gamas, José Paulo Andrade, Bernardo Sousa-Pinto, João Rocha-Neves
<b/>Myocardial injury following noncardiac surgery (MINS) is associated with higher mortality and major adverse cardiovascular event rates in the short- and long-term in patients undergoing carotid endarterectomy (CEA). However, its incidence is still unclear in this subset of patients. Therefore, this systematic review with meta-analysis aims to determine the incidence of MINS in patients undergoing CEA. Three electronic databases MEDLINE, Scopus, and Web of Science were used to search for studies assessing the occurrence of MINS in the postoperative setting of patients undergoing CEA...
January 2024: VASA. Zeitschrift Für Gefässkrankheiten
#23
JOURNAL ARTICLE
Rifly Rafiudeen, Peter Barlis, Raphael Hau, Sheran Vasanthakumar, Reginald Ng, Philip Wu, Mark Tacey, Adrian Banning, William van Gaal
BACKGROUND: Perioperative myocardial injury is common after major noncardiac surgery and is associated with adverse outcomes. This study investigated the use of ivabradine in patients undergoing urgent surgery for fracture. METHODS AND RESULTS: This was a prospective, double-blind, placebo-controlled, randomized clinical trial. Participants were enrolled 1:1 into ivabradine or placebo arm, and study drug was commenced before operation and continued for 7 days or until discharge...
November 20, 2023: Journal of the American Heart Association
#24
JOURNAL ARTICLE
Effect of a national guideline on postoperative troponin surveillance: a retrospective cohort study.
Eva Alvarez Torres, Justyna Bartoszko, Selene Martinez Perez, Gordon Tait, Michael Santema, W Scott Beattie, Stuart A McCluskey, Wilton A van Klei
PURPOSE: We aimed to evaluate the effect of the 2017 Canadian Cardiovascular Society (CCS) guidelines on troponin surveillance after noncardiac surgery. METHODS: This was a single-centre, retrospective, observational study. Patients aged 40 yr or older undergoing intermediate- to high-risk elective noncardiac surgery between 2016 and 2021 were included. We compared the number and percentage of troponin tests ordered before and after the guidelines were published and compared patient characteristics, specifically cardiovascular comorbidity, using odds ratio's (OR) with 95% confidence intervals (CIs)...
November 16, 2023: Canadian Journal of Anaesthesia
#25
JOURNAL ARTICLE
Huayue Liu, Juan Zhang, Ke Peng, Xiaowen Meng, Xisheng Shan, Wenwen Huo, Hong Liu, Yishan Lei, Fuhai Ji
AIMS: Myocardial injury after noncardiac surgery (MINS) is common in elderly patients and considered as an independent predictor of 30-day mortality after noncardiac surgery. Dexmedetomidine possesses cardiac-protective profile. Previous clinical studies have found that perioperative application of dexmedetomidine is associated with decreased 1-year mortality in patients undergoing cardiac surgery. The current study protocol aims to investigate the effects of dexmedetomidine on the incidence of MINS, complications, and 30-day mortality in elderly patients subjected to noncardiac surgery...
November 11, 2023: Perioperative Medicine
#26
JOURNAL ARTICLE
Giovanna Lurati Buse
No abstract text is available yet for this article.
December 1, 2023: European Journal of Anaesthesiology
#27
JOURNAL ARTICLE
Adriene Stahlschmidt, Sávio C Passos, Debora D Dornelles, Carisi Polanczyk, Claudia S Gutierrez, Rosangela R Minuzzi, Stela M J Castro, Luciana C Stefani
PURPOSE: Myocardial injury after noncardiac surgery is common and mostly asymptomatic. The ideal target population that will benefit from routine troponin measurements in low and middle income countries (LMICs) is unclear. This study aims to evaluate the clinical outcomes of a cohort of high-risk surgical patients according to high-sensitivity troponin T (hsTnT) in an LMIC setting. METHODS: We conducted a prospective cohort study of 442 high-risk patients undergoing noncardiac surgery at a Brazilian hospital between February 2019 and March 2020...
November 2023: Canadian Journal of Anaesthesia
#28
JOURNAL ARTICLE
Noemi Glarner, Christian Puelacher, Danielle Menosi Gualandro, Giovanna Lurati Buse, Reka Hidvegi, Daniel Bolliger, Andreas Lampart, Katrin Burri, Mirjam Pargger, Hatice Gerhard, Samantha Weder, Silvia Maiorano, Rebecca Meister, Carla Tschan, Stefan Osswald, Luzius A Steiner, Lorenz Guerke, Elisabeth A Kappos, Martin Clauss, Miodrag Filipovic, Nisha Arenja, Christian Mueller
BACKGROUND: Peri-operative complications are common and associated with high morbidity and mortality. Optimising the use of statins might be of important benefit in peri-operative care and morbidity and mortality. OBJECTIVE: To evaluate adherence to current guideline recommendations regarding statin therapy and its association with peri-operative and long-term cardiac complications. DESIGN: Prospective cohort study. SETTING: Multicentre study with enrolment from October 2014 to February 2018...
September 26, 2023: European Journal of Anaesthesiology
#29
REVIEW
Filippo D'Amico, Evgeny V Fominskiy, Stefano Turi, Alessandro Pruna, Stefano Fresilli, Margherita Triulzi, Alberto Zangrillo, Giovanni Landoni
INTRODUCTION: Intraoperative hypotension is associated with adverse postoperative outcomes; however these findings are supported only by observational studies. The aim of this meta-analysis of randomised trials was to compare the postoperative effects permissive management with targeted management of intraoperative blood pressure. METHODS: We searched PubMed, Cochrane, and Embase up to June 2023 for studies comparing permissive (mean arterial pressure ≤60 mm Hg) with targeted (mean arterial pressure >60 mm Hg) intraoperative blood pressure management...
November 2023: British Journal of Anaesthesia
#30
JOURNAL ARTICLE
Jawad Ahmad Zahid, Adile Orhan, Noor Al-Huda Hadi, Sarah Ekeloef, Ismail Gögenur
PURPOSE: Myocardial injury after noncardiac surgery (MINS) is associated with increased mortality and postoperative complications. In patients with colorectal cancer (CRC), postoperative complications are a risk factor for cancer recurrence and disease-free survival. This study investigates the association between MINS and long-term oncological outcomes in patients with CRC in an ERAS setting. METHODS: This retrospective cohort study was conducted at Zealand University Hospital, Denmark, between June 2015 and July 2017...
September 19, 2023: International Journal of Colorectal Disease
#31
JOURNAL ARTICLE
Pavel S Roshanov, Matthew T V Chan, Flavia K Borges, David Conen, C Y Wang, Denis Xavier, Otavio Berwanger, Maura Marcucci, Daniel I Sessler, Wojciech Szczeklik, Jessica Spence, Pablo Alonso-Coello, Carmen Fernández, Rupert M Pearse, German Malaga, Amit X Garg, Sadeesh K Srinathan, Michael J Jacka, Vikas Tandon, Michael McGillion, Ekaterine Popova, Alben Sigamani, Valsa Abraham, Bruce M Biccard, Juan Carlos Villar, Clara K Chow, Carísi A Polanczyk, Maria Tiboni, Richard Whitlock, Gareth L Ackland, Mohamed Panju, André Lamy, Robert Sapsford, Colin Williams, William Ka Kei Wu, Olga L Cortés, S Danielle MacNeil, Ameen Patel, Emilie P Belley-Côté, Sandra Ofori, William F McIntyre, Darryl P Leong, Diane Heels-Ansdell, Krysten Gregus, P J Devereaux
BACKGROUND: In previous analyses, myocardial injury after noncardiac surgery, major bleeding, and sepsis were independently associated with most deaths in the 30 days after noncardiac surgery, but most of these deaths occurred during the index hospitalization for surgery. The authors set out to describe outcomes after discharge from hospital up to 1 yr after inpatient noncardiac surgery and associations between predischarge complications and postdischarge death up to 1 yr after surgery...
January 1, 2024: Anesthesiology
#32
REVIEW
Zhibing Chen, Yitao Zhang, Weijie Zeng, Lin Ye, Changda Yu, Fan Shi
Non-cardiac surgical procedures present a significant circulatory stress and can potentially trigger cardiovascular events, such as myocardial infarction and heart failure. Myocardial injury before non-cardiac surgery is associated with an increased risk of mortality and major cardiovascular complications during perioperative period, as well as up to 5 years after non-cardiac surgery. While the definition of preoperative myocardial injury is not yet clear, it is generally understood as myocardial injury resulting from various causes of troponin elevation without acute coronary syndrome prior to surgery...
2023: Frontiers in Cardiovascular Medicine
#33
JOURNAL ARTICLE
Ekaterine Popova, Pilar Paniagua-Iglesias, Jesús Álvarez-García, Miquel Vives-Borrás, Aránzazu González-Osuna, Álvaro García-Osuna, Mercedes Rivas-Lasarte, Gisela Hermenegildo-Chavez, Ruben Diaz-Jover, Gonzalo Azparren-Cabezon, Montserrat Barceló-Trias, Abdel-Hakim Moustafa, Raul Aguilar-Lopez, Jordi Ordonez-Llanos, Pablo Alonso-Coello
Perioperative myocardial injury (PMI) is a common cardiac complication. Recent guidelines recommend its systematic screening using high-sensitivity cardiac troponin (hs-cTn). However, there is limited evidence of local screening programs. We conducted a prospective, single-center study aimed at assessing the feasibility and outcomes of implementing systematic PMI screening. Hs-cTn concentrations were measured before and after surgery. PMI was defined as a postoperative hs-cTnT of ≥14 ng/L, exceeding the preoperative value by 50%...
August 18, 2023: Journal of Clinical Medicine
#34
REVIEW
Lijing Yang, Sheng Shi, Jun Li, Zhongrong Fang, Jingfei Guo, Wenying Kang, Jia Shi, Su Yuan, Fuxia Yan, Chenghui Zhou
STUDY OBJECTIVE: To perform a dose-response meta-analysis for the association between postoperative myocardial injury (PMI) in noncardiac surgery and the risk of all-cause mortality or major adverse cardiovascular event (MACE). DESIGN: Dose-response meta-analysis of prospective studies with weighted (WL) or generalized (GL) linear and restricted cubic spline (RCS) regression. SETTING: Teaching hospitals. PATIENTS: Adult patients undergoing noncardiac surgery...
November 2023: Journal of Clinical Anesthesia
#35
JOURNAL ARTICLE
Rebecca Meister, Christian Puelacher, Noemi Glarner, Danielle Menosi Gualandro, Henrik A Andersson, Mirjam Pargger, Gabrielle Huré, Georgiana Virant, Daniel Bolliger, Andreas Lampart, Luzius Steiner, Reka Hidvegi, Giovanna Lurati Buse, Christoph Kindler, Lorenz Gürke, Edin Mujagic, Stefan Schaeren, Martin Clauss, Didier Lardinois, Angelika Hammerer-Lercher, Michelle Chew, Christian Mueller
AIMS: Perioperative myocardial infarction/injury (PMI) is a surprisingly common yet difficult-to-predict cardiac complication in patients undergoing noncardiac surgery. We aimed to assess the incremental value of preoperative cardiac troponin (cTn) concentration in the prediction of PMI. METHODS AND RESULTS: Among prospectively recruited patients at high cardiovascular risk (age ≥65 years or ≥45 years with preexisting cardiovascular disease), PMI was defined as an absolute increase in high-sensitivity cTnT (hs-cTnT) concentration of ≥14 ng/L (the 99th percentile) above the preoperative concentration...
November 16, 2023: European Heart Journal. Acute Cardiovascular Care
#36
EDITORIAL
Bijoy Johnson, Johnson Francis
No abstract text is available yet for this article.
August 4, 2023: American Journal of Cardiology
#37
JOURNAL ARTICLE
Bruno Ferraz de Oliveira Gomes, Thiago Moreira Bastos da Silva, Giovanni Possamai Dutra, Leticia de Sousa Peres, Nathalia Duarte Camisao, Walter de Souza Homena Junior, João Luiz Fernandes Petriz, Plinio Resende do Carmo Junior, Basilio Bragança Pereira, Glaucia Maria Moraes de Oliveira
Myocardial injury after noncardiac surgery (MINS) increases mortality within 30 days. We aimed to evaluate the long-term impact of myocardial injury in a large cohort of patients admitted to intensive care after noncardiac surgery. All patients who stayed, at least, overnight with measurement of high-sensitive cardiac troponin were included. Clinical characteristics and occurrence of MINS were assessed between patients who died and survivors using chi-square test and Student t test. Variables with p <0...
August 2, 2023: American Journal of Cardiology
#38
JOURNAL ARTICLE
(no author information available yet)
No abstract text is available yet for this article.
September 1, 2023: European Journal of Anaesthesiology
#39
JOURNAL ARTICLE
Michael J Jacka, Erik Youngson, David Bigam, Michelle M Graham, Diane Heels-Ansdell, Lily Jaeyoung Park, Charlotte Tiffanie Bendtz Kanstrup, Rahima Nenshi, Sean M Bagshaw, Finlay McAlister, Neesh Pannu, Derek Townsend, Michael S McMurtry, Philip J Devereaux
OBJECTIVE: to determine the prognostic relevance, clinical characteristics, and 30-day outcomes associated with myocardial injury after noncardiac surgery (MINS) in major general surgery patients. BACKGROUND: MINS has been independently associated with 30-day mortality after noncardiac surgery. The characteristics and prognostic importance of MINS in major general surgical patients have not been described. METHODS: This was an international prospective cohort study of a representative sample of 22,552 noncardiac surgery patients 45 years or older, of whom 4490 underwent major general surgery in 24 centers in 13 countries...
July 17, 2023: Annals of Surgery
#40
JOURNAL ARTICLE
Amit X Garg, Meaghan Cuerden, Juan Cata, Matthew T V Chan, P J Devereaux, Edith Fleischmann, Ascensión Martín Grande, Barbara Kabon, Giovanni Landoni, Donna E Maziak, Sean McLean, Chirag Parikh, Ekaterine Popova, Cara Reimer, Juan Carlos Trujillo Reyes, Pavel Roshanov, Daniel I Sessler, Sadeesh Srinathan, Jessica M Sontrop, Anna Gonzalez Tallada, Michael Ke Wang, Jennifer R Wells, David Conen
BACKGROUND: Inflammation during and after surgery can lead to organ damage including acute kidney injury. Colchicine, an established inexpensive anti-inflammatory medication, may help to protect the organs from pro-inflammatory damage. This protocol describes a kidney substudy of the colchicine for the prevention of perioperative atrial fibrillation (COP-AF) study, which is testing the effect of colchicine versus placebo on the risk of atrial fibrillation and myocardial injury among patients undergoing thoracic surgery...
2023: Canadian Journal of Kidney Health and Disease
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