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Perioperative troponin

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https://www.readbyqxmd.com/read/28523165/plasma-levels-of-matrix-metalloproteinase-9-in-patients-undergoing-off-pump-coronary-artery-bypass-grafting
#1
Haiqing Li, Zhize Yuan, Sen Li, Quan Qi, Jun Liu, Mi Zhou, Junfeng Cai, Anqing Chen, Zhe Wang, Xiaofeng Ye, Qiang Zhao
BACKGROUND: Matrix metalloproteinase 9 (MMP9) has recently emerged as a risk predictor in patients with cardiovascular diseases. However, little is known about the significance of increased plasma MMP9 in patients with perioperative myocardial injury. We aimed to investigate the role of MMP9 in the occurrence of myocardial injury during off-pump coronary artery bypass grafting (OPCAB). METHODS: A total of 34 consecutive patients with coronary artery diseases (CAD) were recruited in this prospective, observational study...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28486646/altered-preoperative-coagulation-and-fibrinolysis-are-associated-with-myocardial-injury-after-non-cardiac-surgery
#2
J Górka, K Polok, T Iwaniec, K Górka, A Wludarczyk, J Fronczek, P J Devereaux, J W Eikelboom, J Musial, W Szczeklik
Background: Myocardial injury after non-cardiac surgery (MINS), a complication with unclear pathogenesis, occurs within the first 30 days after surgery and worsens prognosis. Hypercoagulability induced by surgery might contribute to plaque rupture, with subsequent thrombosis and myocardial injury. This study assessed haemostatic markers before surgery and evaluated their association with MINS. Methods: This is a substudy of VISION, a prospective cohort study of perioperative cardiovascular events...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28455997/prognostic-value-of-perioperative-assessment-of-plasma-cardiac-troponin-i-in-patients-undergoing-liver-transplantation
#3
Krzysztof Jankowski, Janusz Trzebicki, Maksymilian Bielecki, Beata Łągiewska, Katarzyna Kurnicka, Magdalena Koczaj-Bremer, Marek Pacholczyk, Piotr Pruszczyk
An elevation in plasma cardiac troponins is an indicator of increased perioperative risk in orthopaedic and vascular surgery, however, data on liver transplantation (LTx) are scarce. The aim of the study was to evaluate the prevalence of cardiac troponin I (cTnI) elevation in the perioperative period of LTx, and its potential relationship with 1-year mortality. MATERIAL AND METHODS: Analysis included 79 patients with liver cirrhosis. During LTx all patients underwent hemodynamic measurements...
April 25, 2017: Acta Biochimica Polonica
https://www.readbyqxmd.com/read/28444280/association-of-postoperative-high-sensitivity-troponin-levels-with-myocardial-injury-and-30-day-mortality-among-patients-undergoing-noncardiac-surgery
#4
P J Devereaux, Bruce M Biccard, Alben Sigamani, Denis Xavier, Matthew T V Chan, Sadeesh K Srinathan, Michael Walsh, Valsa Abraham, Rupert Pearse, C Y Wang, Daniel I Sessler, Andrea Kurz, Wojciech Szczeklik, Otavio Berwanger, Juan Carlos Villar, German Malaga, Amit X Garg, Clara K Chow, Gareth Ackland, Ameen Patel, Flavia Kessler Borges, Emilie P Belley-Cote, Emmanuelle Duceppe, Jessica Spence, Vikas Tandon, Colin Williams, Robert J Sapsford, Carisi A Polanczyk, Maria Tiboni, Pablo Alonso-Coello, Atiya Faruqui, Diane Heels-Ansdell, Andre Lamy, Richard Whitlock, Yannick LeManach, Pavel S Roshanov, Michael McGillion, Peter Kavsak, Matthew J McQueen, Lehana Thabane, Reitze N Rodseth, Giovanna A Lurati Buse, Mohit Bhandari, Ignacia Garutti, Michael J Jacka, Holger J Schünemann, Olga Lucía Cortes, Pierre Coriat, Nazari Dvirnik, Fernando Botto, Shirley Pettit, Allan S Jaffe, Gordon H Guyatt
Importance: Little is known about the relationship between perioperative high-sensitivity troponin T (hsTnT) measurements and 30-day mortality and myocardial injury after noncardiac surgery (MINS). Objective: To determine the association between perioperative hsTnT measurements and 30-day mortality and potential diagnostic criteria for MINS (ie, myocardial injury due to ischemia associated with 30-day mortality). Design, Setting, and Participants: Prospective cohort study of patients aged 45 years or older who underwent inpatient noncardiac surgery and had a postoperative hsTnT measurement...
April 25, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28442930/thoracic-epidural-analgesia-reduces-myocardial-injury-in-ischemic-patients-undergoing-major-abdominal-cancer-surgery
#5
Mohamad Farouk Mohamad, Montaser A Mohammad, Diab F Hetta, Eman Hasan Ahmed, Ahmed A Obiedallah, Alaa Ali M Elzohry
BACKGROUND AND OBJECTIVES: Major abdominal cancer surgeries are associated with significant perioperative mortality and morbidity due to myocardial ischemia and infarction. This study examined the effect of perioperative patient controlled epidural analgesia (PCEA) on occurrence of ischemic cardiac injury in ischemic patients undergoing major abdominal cancer surgery. PATIENTS AND METHODS: One hundred and twenty patients (American Society of Anesthesiologists grade II and III) of either sex were scheduled for elective upper gastrointestinal cancer surgeries...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28395591/volatile-anaesthetics-added-to-cardiopulmonary-bypass-are-associated-with-reduced-cardiac-troponin
#6
Elena Bignami, Marcello Guarnieri, Marina Pieri, Francesco De Simone, Alcira Rodriguez, Luigi Cassarà, Rosalba Lembo, Giovanni Landoni, Alberto Zangrillo
BACKGROUND: Every year, over 1 million cardiac surgical procedures are performed all over the world. Reducing myocardial necrosis could have strong implications in postoperative clinical outcomes. Volatile anaesthetics have cardiac protective properties in the perioperative period of cardiac surgery. However, little data exists on the administration of volatile agents during cardiopulmonary bypass. The aim of this study was to assess if volatile anaesthetics administration during cardiopulmonary bypass reduces cardiac troponin release after cardiac surgery...
March 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28356068/a-randomized-trial-of-remote-ischemic-preconditioning-and-control-treatment-for-cardioprotection-in-sevoflurane-anesthetized-cabg-patients
#7
Rianne Nederlof, Nina C Weber, Nicole P Juffermans, Bas A M J de Mol, Markus W Hollmann, Benedikt Preckel, Coert J Zuurbier
BACKGROUND: Remote ischemic preconditioning (RIPC) efficacy is debated. Possibly, because propofol, which has a RIPC-inhibiting action, is used in most RIPC trials. It has been suggested that clinical efficacy is, however, present with volatile anesthesia in the absence of propofol, although this is based on one phase 1 trial only. Therefore, in the present study we further explore the relation between RIPC and cardioprotection with perioperative anesthesia restricted to sevoflurane and fentanyl, in CABG patients without concomitant procedures...
March 29, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28319568/predictive-value-of-intraoperative-troponin-i-elevation-in-pediatric-living-donor-liver-transplant-recipients-with-biliary-atresia
#8
Mingwei Sheng, Yuanbang Lin, Yiqi Weng, Rubin Xu, Ying Sun, Wenli Yu, Hongyin Du
BACKGROUND: Pediatric living donor liver transplantation is associated with slight alteration in cardiac enzymes without ongoing acute cardiac injury, but available information about the significance of these changes is limited. The aims of this study were to analyze the link between the anomalies of intraoperative serum cardiac troponin I (cTnI) and acute lung injury during the first week after liver transplantation. METHODS: In this retrospective study, 123 children suffered from biliary atresia were enrolled...
March 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28292587/diagnosis-of-perioperative-myocardial-infarction-after-heart-valve-surgery-with-new-cut-off-point-of-high-sensitivity-troponin-t-and-new-electrocardiogram-or-echocardiogram-changes
#9
Héctor Cubero-Gallego, Mario Lorenzo, María Heredia, Itziar Gómez, Eduardo Tamayo
OBJECTIVE: Criteria for diagnosing myocardial infarction (MI) after heart valve surgery are not collected in the Third Universal Definition of MI. We aimed to define cut-offs for high-sensitivity cardiac troponin T (hs-cTnT) and creatine kinase-MB (CK-MB) for the diagnosis of perioperative MI after heart valve surgery according to perioperative MI determined by new alterations in electrocardiogram (ECG) and/or transthoracic echocardiogram (TTE). Secondary endpoints were incidence of perioperative MI, postoperative complications, 30-day mortality, and 2-year survival...
February 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28207554/isolated-cardiac-troponin-rise-does-not-modify-the-prognosis-in-elderly-patients-with-hip-fracture
#10
Hélène Vallet, Alice Breining, Yannick Le Manach, Judith Cohen-Bittan, Anthony Mézière, Mathieu Raux, Marc Verny, Bruno Riou, Frédéric Khiami, Jacques Boddaert
Perioperative myocardial infarction remains a life-threatening complication in noncardiac surgery and even an isolated troponin rise (ITR) is associated with significant mortality. Our aim was to assess the prognostic value of ITR in elderly patients with hip fracture.In this cohort study, all patients admitted between 2009 and 2013 in our dedicated geriatric postoperative unit after hip fracture surgery with a cardiac troponin I determination were included and divided into Control, ITR, and acute coronary syndrome (ACS) groups...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28152655/inflammatory-cytokine-response-and-cardiac-troponin-i-changes-in-cardiopulmonary-bypass-using-two-cardioplegia-solutions-del-nido-and-modified-st-thomas-a-randomized-controlled-trial
#11
Farhad Gorjipour, Maziar Gholampour Dehaki, Ziae Totonchi, Seyed Javad Hajimiresmaiel, Rasoul Azarfarin, Hamidreza Pazoki-Toroudi, Mohammad Mahdavi, Mahtab Korbi, Mahyar Gholampour Dehaki, Behrouz Soltani, Fazel Gorjipour
BACKGROUND: Long intervals of del Nido (DN) solution administration, 90 minutes, may result in rewarming of the myocardial tissue and elevate metabolic demand and hypoxia. This will potentially increase inflammatory response due to ischemia-reperfusion injury. We conducted this study to compare the inflammatory response between patients receiving DN and multi-dose St Thomas' cardioplegia solution (MST) in cardiopulmonary bypass (CPB) surgery for the correction of tetralogy of Fallot (TF)...
February 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28131774/high-sensitivity-troponin-release-profile-after-cardiac-surgery
#12
Phuong L Markman, John-Paul Tantiongco, Jayme S Bennetts, Robert A Baker
BACKGROUND: Postoperative serum troponin levels and perioperative myocardial infarction (MI) rates correlate with mortality and morbidity following cardiac surgery. The objective of this study was to document the release profile of high sensitivity troponin T (hsTnT) following different cardiac operations. METHODS: Patients undergoing one of five different isolated cardiac surgical procedures (eligible preoperative hsTnT <29ng/L, serum creatinine < 0.2mmol/L) were recruited prospectively...
December 23, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28062620/application-of-cardiac-troponin-in-cardiovascular-diseases-other-than-acute-coronary-syndrome
#13
REVIEW
Kai M Eggers, Bertil Lindahl
BACKGROUND: Increased cardiac troponin concentrations in acute coronary syndrome (ACS) identify patients with ongoing cardiomyocyte necrosis who are at increased risk. However, with the use of more precise assays, cardiac troponin increases are commonly noted in other cardiovascular conditions as well. This has generated interest in the use of cardiac troponin for prognostic assessment and clinical management of these patients. In this review, we have summarized the data from studies investigating the implications of cardiac troponin concentrations in various acute and chronic conditions beyond ACS, i...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/27932153/a-heartbreaking-renal-transplantation-is-norepinephrine-the-culprit-to-blame
#14
M G Vailas, S Vernadakis, K Kakavia, I Paizis, J Bokos, J Boletis, G Zavos
INTRODUCTION: Takotsubo cardiomyopathy (TCM), also known as "broken heart syndrome," "apical ballooning syndrome," and "stress-induced cardiomyopathy," was first described in Japanese patients in 1990 by Sato et al. TCM is an increasingly recognized syndrome characterized by transient and reversible systolic dysfunction of the apical and middle segments of the left ventricle. This syndrome resembles acute myocardial infarction in the absence of evident coronary artery occlusion. Herein, we present a case of a 51-year-old male who underwent his second deceased-donor renal transplantation for end-stage-renal-disease due to a work-related accident...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27919716/postoperative-cardiac-ischemia-detection-by-continuous-12-lead-electrocardiographic-monitoring-in-vascular-surgery-patients-a-prospective-observational-study
#15
Aino Ollila, Juha Virolainen, Joonas Vanhatalo, Pirkka Vikatmaa, Ilkka Tikkanen, Maarit Venermo, Markku Salmenperä, Ville Pettilä, Leena Vikatmaa
OBJECTIVES: Elderly patients undergoing vascular surgery are at major risk for perioperative cardiac complications. The authors investigated continuous electrocardiographic Holter monitoring in a postoperative setting to determine the degree of postoperative ischemic load and its possible associations with perioperative myocardial infarction. DESIGN: A prospective, observational study. SETTING: One university hospital. PARTICIPANTS: The study comprised 51 patients aged 65 years or older undergoing peripheral arterial surgery...
September 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27882105/a-pilot-study-of-perioperative-esmolol-for-myocardial-protection-during-on-pump-cardiac-surgery
#16
Xue Liu, Fengxia Shao, Liu Yang, Youhai Jia
The protective effects of preprocedural esmolol on myocardial injury and hemodynamics have not, to date, been investigated in patients who were scheduled for cardiac surgeries under a cardiopulmonary bypass (CPB). A pilot randomized controlled trial was performed at The First Affiliated Hospital of Dalian Medical University (Dalian, China). Patients scheduled for elective open-heart surgeries under CBP were included, and were randomized to esmolol and control groups. For patients in the esmolol groups, intravenous esmolol (70 µg/kg/min) was administered at the time of incision until CPB was performed...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27870734/incremental-value-of-preoperative-copeptin-for-predicting-myocardial-injury
#17
Eckhard Mauermann, Daniel Bolliger, Esther Seeberger, Christian Puelacher, Sydney Corbiere, Miodrag Filipovic, Manfred Seeberger, Christian Mueller, Giovanna Lurati Buse
BACKGROUND: Copeptin, a novel marker of endogenous stress, has shown diagnostic and prognostic value in nonsurgical patients with a suspected coronary event. We aimed to assess the incremental value of copeptin in addition to established preoperative risk indices to predict the occurrence of postoperative myocardial injury. METHODS: This secondary analysis of prospectively collected data included adults undergoing noncardiac surgery with risk factors for adverse perioperative cardiac events based on preoperative risk stratification...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27865641/canadian-cardiovascular-society-guidelines-on-perioperative-cardiac-risk-assessment-and-management-for-patients-who-undergo-noncardiac-surgery
#18
Emmanuelle Duceppe, Joel Parlow, Paul MacDonald, Kristin Lyons, Michael McMullen, Sadeesh Srinathan, Michelle Graham, Vikas Tandon, Kim Styles, Amal Bessissow, Daniel I Sessler, Gregory Bryson, P J Devereaux
The Canadian Cardiovascular Society Guidelines Committee and key Canadian opinion leaders believed there was a need for up to date guidelines that used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system of evidence assessment for patients who undergo noncardiac surgery. Strong recommendations included: 1) measuring brain natriuretic peptide (BNP) or N-terminal fragment of proBNP (NT-proBNP) before surgery to enhance perioperative cardiac risk estimation in patients who are 65 years of age or older, are 45-64 years of age with significant cardiovascular disease, or have a Revised Cardiac Risk Index score ≥ 1; 2) against performing preoperative resting echocardiography, coronary computed tomography angiography, exercise or cardiopulmonary exercise testing, or pharmacological stress echocardiography or radionuclide imaging to enhance perioperative cardiac risk estimation; 3) against the initiation or continuation of acetylsalicylic acid for the prevention of perioperative cardiac events, except in patients with a recent coronary artery stent or who will undergo carotid endarterectomy; 4) against α2 agonist or β-blocker initiation within 24 hours before surgery; 5) withholding angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker starting 24 hours before surgery; 6) facilitating smoking cessation before surgery; 7) measuring daily troponin for 48 to 72 hours after surgery in patients with an elevated NT-proBNP/BNP measurement before surgery or if there is no NT-proBNP/BNP measurement before surgery, in those who have a Revised Cardiac Risk Index score ≥1, age 45-64 years with significant cardiovascular disease, or age 65 years or older; and 8) initiating of long-term acetylsalicylic acid and statin therapy in patients who suffer myocardial injury/infarction after surgery...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27833481/cardiac-and-renal-protective-effects-of-dexmedetomidine-in-cardiac-surgeries-a-randomized-controlled-trial
#19
A S Ammar, K M Mahmoud, Z A Kasemy, M A Helwa
BACKGROUND: Cardiac and renal injuries are common insults after cardiac surgeries that contribute to perioperative morbidity and mortality. Dexmedetomidine has been shown to protect several organs against ischemia/reperfusion-(I/R) induced injury. We performed a randomized controlled trial to assess the effect of dexmedetomidine on cardiac and renal I/R injury in patients undergoing cardiac surgeries. MATERIALS AND METHODS: Fifty patients scheduled for elective cardiac surgeries were randomized to dexmedetomidine group that received a continuous infusion of dexmedetomidine initiated 5 min before cardiopulmonary bypass (1 μg/kg over 15 min, followed by 0...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27775784/serum-troponin-i-concentrations-assessed-18-24-hours-after-coronary-artery-bypass-grafting-are-significant-predictors-of-early-patient-prognosis
#20
Q-L Ma, H-J Wang, M-N Shi, J-H An, J Ma, D Yu, M Tang, F-W Shi
OBJECTIVE: Coronary heart disease (CHD) is a frequent medical condition in developed countries and is one of the most serious diseases threatening patients' lives. Perioperative myocardial infarction is the major cause of perioperative cardiac death and cardiac arrest, but is difficult to be precisely identified by observing clinical symptoms or assessing cardiac enzyme levels or by ECG examination. Therefore, assessment of patient prognosis requires reliable predictors. In this regard, we tested the prognostic value of serum troponin I (TnI) concentrations...
October 2016: European Review for Medical and Pharmacological Sciences
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