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Perioperative troponin

Annette L Mazzone, Robert A Baker, Kym McNicholas, Richard J Woodman, Michael Z Michael, Jonathan M Gleadle
A pilot study to measure and compare blood and urine microRNAs miR-210 and miR-16 in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) and off-pump coronary artery bypass grafting surgery. Frequent serial blood and urine samples were taken from patients undergoing cardiac surgery with CPB (n = 10) and undergoing off-pump cardiac surgery (n = 5) before, during, and after surgery. Circulating miR-210 and miR-16 levels were determined by relative quantification real-time polymerase chain reaction...
March 2018: Journal of Extra-corporeal Technology
Aditya Mandawat, L Kristin Newby
No abstract text is available yet for this article.
March 20, 2018: Circulation
Hector Cubero-Gallego, Maria Heredia-Rodriguez, Eduardo Tamayo
We aimed to assess the influence of impairment in renal function over the high-sensitivity cardiac troponin T (hs-cTnT) accuracy to diagnose perioperative myocardial infarction (MI) after heart valve surgery. Heart valve surgery was performed in 805 patients from June 2012 to January 2016. Patients with enzymatic curves of hs-cTnT suggestive of myocardial necrosis and electrocardiogram and/or transthoracic echocardiogram criteria were identified as patients with perioperative MI. Impairment in renal function was defined as a postoperative creatinine clearance <50 ml/min at 16 h after surgery and for at least 48 h...
March 12, 2018: Interactive Cardiovascular and Thoracic Surgery
Mladjan Golubovic, Radmilo Jankovic, Dusan Sokolovic, Vladan Cosic, Vesna Maravic, Tomislav Kostic, Zoran Perisic, Nebojsa Ladjevic
OBJECTIVE: We evaluated the utility of preoperative mid-regional pro-adrenomedulin (MR-proADM) and cardiac troponin T (TnT) for improved detection of patients at high risk for perioperative cardiac events and mortality after major non-cardiac surgery. SUBJECTS AND METHODS: This prospective, single-center, observational study enrolled 79 patients undergoing major non-cardiac surgery. After initial clinical assessment (clinical history, physical examination, echocardiogram, blood tests, and chest X-ray), mid-regional pro-adrenomedulin and high sensitivity troponin T (hsTnT) were measured within 48 hours prior to surgery by immunoluminometric and electrochemiluminescence-immuno assay...
March 7, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Anahat K Dhillon, Andrew A Disque, Christine T Nguyen-Buckley, Tristan R Grogan, Dana L Russell, H Albin Gritsch, Jacques P Neelankavil
Our study of 100 major vascular and renal transplant patients evaluated the 6-minute walk test (6MWT) as an indicator of perioperative myocardial injury, using troponin as a marker. Using logistic regression and the area under the receiving operator characteristic curve, we compared the 6MWT to the Revised Cardiac Risk Index and metabolic equivalents. Only the 6MWT was associated with elevated postoperative troponins (95% CI, 0.98-0.99). However, the 6MWT area under the receiving operator characteristic curve (0...
February 23, 2018: Anesthesia and Analgesia
Philippe Grieshaber, Tobias Schneider, Lukas Oster, Coskun Orhan, Peter Roth, Bernd Niemann, Andreas Böning
INTRODUCTION: Prophylactic intra-aortic balloon counterpulsation (pIABC) is recommended for high-risk patients undergoing coronary artery bypass grafting (CABG) surgery. Criteria for high-risk patients benefiting from pIABC are unclear. This study aimed to specifically describe the effect of pIABC on outcomes of patients with acute myocardial infarction (AMI) undergoing CABG. METHODS: In 178 of 484 AMI patients (non-ST-segment elevation myocardial infarction [NSTEMI] or ST-segment elevation myocardial infarction [STEMI] ≤5 days before surgery) without cardiogenic shock who underwent CABG between 2008 and 2013, pIABC was initiated preoperatively...
February 1, 2018: Perfusion
Benedikte T Smenes, Fredrik H Bækkerud, Katrine H Slagsvold, Erlend Hassel, Martin Wohlwend, Maria Pinho, Morten Høydal, Ulrik Wisløff, Øivind Rognmo, Alexander Wahba
OBJECTIVES: During open-heart surgery, the myocardium experiences ischaemia-reperfusion injury. A single bout of moderate, 30-min exercise induces preconditioning and protects the heart from ischaemia-reperfusion injury in rats, but this has never been investigated in humans. We aimed to investigate whether 1 bout of moderate exercise 24 h prior to surgery protects against mitochondrial and cardiac damage. METHODS: Patients scheduled for elective coronary artery bypass were eligible for this pilot study...
February 13, 2018: Interactive Cardiovascular and Thoracic Surgery
Shun Huang, WenPing Peng, Ning Yang, Tao Yu, Hong Yuan Cui, Jing Yong Xu, Qi An, Hua Yang, Yan Nan Liu, Zhe Li, Ming Zhang Zuo
BACKGROUND: The development of sensitive myocardial-specific cardiac biomarkers allows for detection of very small amounts of myocardial injury or necrosis. Myocardial injury (MI) as a prelude of the serious perioperative complication myocardial infarction, should be paid more attention, especially in elderly susceptible patients. Myocardial injury after abdominal surgery in elderly patients has not been described yet. The objectives of this study were to identify the incidence, predictors, characteristics and the impact of MI on outcome in elderly patients underwent abdominal surgery...
February 12, 2018: Aging Clinical and Experimental Research
Anne R Bass, Jackie D Szymonifka, Matthew T Rondina, Margaret Bogardus, Mitchell G Scott, Scott C Woller, Scott M Stevens, Charles Eby, Kerri Merritt, Alejandro Gonzalez Della Valle, Gerard Moskowitz, Eva Flores, Brian F Gage
Background: Orthopedic patients are at risk for adverse postoperative cardiovascular outcomes. Questions/Purposes: This pilot randomized controlled trial (RCT) of atorvastatin vs. placebo in orthopedic surgery patients was performed in order to assess: (1) the prevalence of perioperative myocardial injury; (2) the effect of atorvastatin on perioperative inflammation; and (3) the feasibility of performing a large RCT of statin therapy in orthopedic patients. Methods: Hip fracture (hip Fx) and total hip and knee replacement (THR and TKR) patients were randomized 1:1 to atorvastatin 40 mg daily vs...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Abhijit Lele, Viharika Lakireddy, Sergii Gorbachov, Nophanan Chaikittisilpa, Vijay Krishnamoorthy, Monica S Vavilala
BACKGROUND: The recommended cardiac workup of patients with spontaneous intracerebral hemorrhage (ICH) includes an electrocardiogram (ECG) and cardiac troponin. However, abnormalities in other cardiovascular domains may occur. We reviewed the literature to examine the spectrum of observed cardiovascular abnormalities in patients with ICH. METHODS: A narrative review of cardiovascular abnormalities in ECG, cardiac biomarkers, echocardiogram, and hemodynamic domains was conducted on patients with ICH...
January 31, 2018: Journal of Neurosurgical Anesthesiology
Marcel Baschin, Sixten Selleng, Astrid Hummel, Stephan Diedrich, Henry W Schroeder, Thomas Kohlmann, Antje Westphal, Andreas Greinacher, Thomas Thiele
BACKGROUND: Patients receiving antiplatelet therapy (APT) have an increased risk of perioperative bleeding and cardiac adverse events (CAE). Preoperative platelet transfusions may reduce the bleeding risk but may also increase the risk of CAE, particularly coronary thrombosis in patients after recent stent implantation. OBJECTIVES: To analyse the incidence of perioperative CAE and bleeding in patients undergoing non-cardiac surgery using a standardized management of transfusing two platelet concentrates pre-operatively and restart of APT within 24-72 hours after surgery...
January 31, 2018: Journal of Thrombosis and Haemostasis: JTH
Peter Poredos, Pavel Poredos
Surgical procedures represent a risk for different complications which may appear during the perioperative period. Cardiac ischemic events and vascular complications are the most important causes of increased morbidity and mortality and they are much more frequent in patients with manifest cardiovascular disease. This is particularly seen in patients with peripheral arterial occlusive disease (PAD), which represents advanced atherosclerosis frequently accompanied by the presence of coronary artery disease. Therefore, patients with PAD need careful preoperative examination, including estimation of functional capacity and the presence of other co-existing atherosclerotic diseases...
January 11, 2018: International Angiology: a Journal of the International Union of Angiology
Zhi Wang, Qiang Chen, Hao Guo, Zhishan Li, Jinfeng Zhang, Lei Lv, Yongqing Guo
This study investigated the effects of dexmedetomidine on heart-type fatty acid binding protein (H-FABP), creatine kinase isoenzymes (CK-MB), and troponin I (cTnI) levels, neurological function and near-term prognosis in patients undergoing heart valve replacement. Patients undergoing heart valve replacement were randomly allocated to remifentanil anesthesia (control group, n=48) or dexmedetomidine anesthesia (observation group, n=48). Hemodynamic parameters were measured before anesthesia induction (T1), 1 min after intubation (T2), 10 min after start of surgery (T3), and on completion of surgery (T4)...
December 2017: Experimental and Therapeutic Medicine
Ping Hua, Jianyang Liu, Jun Tao, Rongjun Zou, Xifeng Lin, Dingwen Zhang, Songran Yang
Background: Cardiopulmonary bypass (CPB) causes systemic inflammatory response and ischemia-reperfusion (IR) injury. Objective: To investigate the effect and mechanism of simvastatin on myocardial injury in cardiac valve surgery with CPB. Methods: One hundred thirty patients were randomly assigned to the statin group (n = 65) or control group (n = 65). Simvastatin was administered preoperatively and postoperatively. Duration of intensive care unit stay, duration of assisted ventilation, and left ventricular ejection fraction were recorded...
2017: BioMed Research International
Jean-Sébastien Lebon, Pierre Couture, Annik Fortier, Antoine G Rochon, Christian Ayoub, Claudia Viens, Éric Laliberté, Denis Bouchard, Michel Pellerin, Alain Deschamps
OBJECTIVE: To compare antegrade and retrograde cardioplegia administration in minimally invasive mitral valve surgery (MIMS) and open mitral valve surgery (OMS) for myocardial protection. DESIGN: Retrospective study. SETTING: Tertiary care university hospital. PARTICIPANTS: The study comprised 118 patients undergoing MIMS and 118 patients undergoing OMS. INTERVENTIONS: The data of patients admitted for MIMS from 2006 to 2010 were reviewed...
August 30, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Christian Puelacher, Giovanna Lurati Buse, Daniela Seeberger, Lorraine Sazgary, Stella Marbot, Andreas Lampart, Jaqueline Espinola, Christoph Kindler, Angelika Hammerer, Esther Seeberger, Ivo Strebel, Karin Wildi, Raphael Twerenbold, Jeanne du Fay de Lavallaz, Luzius Steiner, Lorenz Gurke, Tobias Breidthardt, Katharina Rentsch, Andreas Buser, Danielle M Gualandro, Stefan Osswald, Christian Mueller
Background -Perioperative myocardial injury (PMI) seems to be a contributor to mortality after noncardiac surgery. Because the vast majority of PMIs are asymptomatic, PMI usually is missed in the absence of systematic screening. Methods -We performed a prospective diagnostic study enrolling consecutive patients undergoing noncardiac surgery who had a planned postoperative stay of ≥24 hours and were considered at increased cardiovascular risk. All patients received a systematic screening using serial measurements of high-sensitivity cardiac troponin T in clinical routine...
December 4, 2017: Circulation
P Foëx
Within the last generation, the management of patients with heart disease has been transformed by advances in drug treatments, interventions and diagnostic technologies. The management of arterial hypertension saw beta-blockers demoted from first- to third-line treatment. Recent studies suggest that the goal of treatment may have to change to lower systolic blood pressures to prevent long-term organ damage. Today less than 15% of coronary revascularizations are surgical and more than 85% are done by interventional cardiologists inserting coronary stents...
December 1, 2017: British Journal of Anaesthesia
Hironobu Toda, Kazufumi Nakamura, Koji Nakagawa, Atsuyuki Watanabe, Toru Miyoshi, Nobuhiro Nishii, Kazuyoshi Shimizu, Masao Hayashi, Hiroshi Morita, Hiroshi Morimatsu, Hiroshi Ito
BACKGROUND: High-sensitivity cardiac troponin T (hs-cTnT) is useful for detecting myocardial injury and is expected to become a prognostic marker in patients undergoing non-cardiac surgery. The aim of this pilot study evaluating the efficacy of β-blocker therapy in a perioperative setting (MAMACARI study) was to assess perioperative myocardial injury (PMI) in elderly patients with preserved ejection fraction (EF) undergoing non-cardiac surgery.Methods and Results:In this prospective observational cohort study of 151 consecutive patients with preserved EF and aged >60 years who underwent non-cardiac surgery, serum levels of hs-cTnT were measured before and on postoperative days 1 and 3 after surgery...
November 18, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
David Montaigne, Xavier Marechal, Thomas Modine, Augustin Coisne, Stéphanie Mouton, Georges Fayad, Sandro Ninni, Cédric Klein, Staniel Ortmans, Claire Seunes, Charlotte Potelle, Alexandre Berthier, Celine Gheeraert, Catherine Piveteau, Rebecca Deprez, Jérome Eeckhoute, Hélène Duez, Dominique Lacroix, Benoit Deprez, Bruno Jegou, Mohamed Koussa, Jean-Louis Edme, Philippe Lefebvre, Bart Staels
BACKGROUND: On-pump cardiac surgery provokes a predictable perioperative myocardial ischaemia-reperfusion injury which is associated with poor clinical outcomes. We determined the occurrence of time-of-the-day variation in perioperative myocardial injury in patients undergoing aortic valve replacement and its molecular mechanisms. METHODS: We studied the incidence of major adverse cardiac events in a prospective observational single-centre cohort study of patients with severe aortic stenosis and preserved left ventricular ejection fraction (>50%) who were referred to our cardiovascular surgery department at Lille University Hospital (Lille, France) for aortic valve replacement and underwent surgery in the morning or afternoon...
October 26, 2017: Lancet
Tom E F Abbott, Rupert M Pearse, R Andrew Archbold, Tahania Ahmad, Edyta Niebrzegowska, Andrew Wragg, Reitze N Rodseth, Philip J Devereaux, Gareth L Ackland
BACKGROUND: The association between intraoperative cardiovascular changes and perioperative myocardial injury has chiefly focused on hypotension during noncardiac surgery. However, the relative influence of blood pressure and heart rate (HR) remains unclear. We investigated both individual and codependent relationships among intraoperative HR, systolic blood pressure (SBP), and myocardial injury after noncardiac surgery (MINS). METHODS: Secondary analysis of the Vascular Events in Noncardiac Surgery Cohort Evaluation (VISION) study, a prospective international cohort study of noncardiac surgical patients...
October 26, 2017: Anesthesia and Analgesia
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