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Perioperative troponin

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https://www.readbyqxmd.com/read/29747289/-an-analysis-of-the-characteristics-of-perioperative-cardiac-troponin-elevation-in-orthopaedic-surgical-patients
#1
W L Hu, Y Z Chen, J H Wang, X L Hao, D X Zhai, H Y Sun, X S Zhao
Objective: Perioperative myocardial infarction remains a severe complication in non-cardiac surgery and is one of the major causes of death. Cardiac troponin (cTn) I elevation is associated with short-term and long-term mortality. The aim of the study was to assess the proportion rate of cTnI elevation and its clinical characteristics among patients admitted for orthopaedic surgery with or without cardiovascular events. Methods: This is a retrospective study including 27 744 patients aged 50 years or older who admitted for orthopaedic surgery from 2009-2015 in Beijing Jishuitan Hospital...
May 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29707299/cold-crystalloid-versus-warm-blood-cardioplegia-in-patients-undergoing-aortic-valve-replacement
#2
Paolo Nardi, Sara R Vacirca, Marco Russo, Dionisio F Colella, Carlo Bassano, Antonio Scafuri, Antonio Pellegrino, Gerry Melino, Giovanni Ruvolo
Background: Myocardial protection techniques during cardiac arrest have been extensively investigated in the clinical setting of coronary revascularization. Fewer studies have been carried out of patients affected by left ventricular hypertrophy, where the choice of type and temperature of cardioplegia remain controversial. We have retrospectively investigated myocardial injury and short-term outcome in patients undergoing aortic valve replacement plus or minus coronary artery bypass grafting with using cold crystalloid cardioplegia (CCC) or warm blood cardioplegia (WBC)...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29630122/analysis-of-the-correlation-between-the-neutrophil-lymphocyte-ratio-in-peripheral-blood-and-perioperative-myocardial-damage-in-pediatric-patients-with-frequent-ventricular-premature-beat
#3
J Tian, X-J An, L Niu
OBJECTIVE: The objective of the present study was to investigate the relationship between the neutrophil-lymphocyte ratio (NLR) in peripheral blood and myocardial damage in pediatric patients with frequent ventricular premature beat (FVPB), and provide a reference for myocardial preservation in these patients. PATIENTS AND METHODS: A total of 212 pediatric patients who were treated in the Department of Cardiology, Xuzhou Children's Hospital between December 2014 and March 2016 for FVPB, were selected...
March 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29628586/postoperative-cardiac-surgery-outcomes-in-a-statin-native-population
#4
Sameh Aboulnaga, Ahmed Mahfouz, Hesham A Ewila, Alejandro Kohn Tuli, Rajvir Singh, Amr S Omar, Abdulaziz Al Khualifi
Background: Statin utilization had been associated with improved survival after cardiac surgery. We aim to study whether perioperative treatment with statin could be associated with increased postoperative complications. Design: This was a retrospective, descriptive, single-center study. Settings: We analyzed morbidity after cardiac surgery as well as the outcome related to statin therapy in a tertiary cardiac center. Patients: A total of 202 consecutive patients were enrolled over 1 year after cardiac surgery...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29589418/myocardial-injury-after-non-cardiac-surgery-a-perioperative-affair
#5
Viviana Miccichè, Cesare Baldi, Edoardo DE Robertis, Ornella Piazza
Myocardial injury after non cardiac surgery (MINS) is a rather new nosological entity and an unfortunately common perioperative complication. The diagnostic criteria for MINS, also indicated as isolated myocardi- al injury (IMI), are an elevated postoperative high sensitivity Troponin T (hsTnT level ranging between 20 and 65 ng/L with an absolute change of at least 5 ng/L or hsTnT level > 65 ng/L), in absence of symptoms and/or EKG findings suggestive of ischemia and without a non ischemic aetiology causing Troponin eleva- tion...
March 27, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29559751/circulating-and-urinary-mir-210-and-mir-16-increase-during-cardiac-surgery-using-cardiopulmonary-bypass-a-pilot-study
#6
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
https://www.readbyqxmd.com/read/29555707/high-sensitivity-troponin-in-noncardiac-surgery-pandora-s-box-or-opportunity-for-precision-perioperative-care
#7
EDITORIAL
Aditya Mandawat, L Kristin Newby
No abstract text is available yet for this article.
March 20, 2018: Circulation
https://www.readbyqxmd.com/read/29538657/influence-of-impairment-in-renal-function-on-the-accuracy-of-high-sensitivity-cardiac-troponin-t-for-the-diagnosis-of-perioperative-myocardial-infarction-after-heart-valve-surgery
#8
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
https://www.readbyqxmd.com/read/29514145/preoperative-midrregional-proadrenomedulin-and-high-sensitivity-troponin-t-predict-perioperative-cardiovascular-events-in-non-cardiac-surgery
#9
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
https://www.readbyqxmd.com/read/29481433/does-a-low-6-minute-walk-distance-predict-elevated-postoperative-troponin
#10
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
https://www.readbyqxmd.com/read/29457560/prophylactic-intra-aortic-balloon-counterpulsation-before-surgical-myocardial-revascularization-in-patients-with-acute-myocardial-infarction
#11
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
https://www.readbyqxmd.com/read/29447379/acute-exercise-is-not-cardioprotective-and-may-induce-apoptotic-signalling-in-heart-surgery-a-randomized-controlled-trial
#12
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
https://www.readbyqxmd.com/read/29435832/myocardial-injury-in-elderly-patients-after-abdominal-surgery
#13
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
https://www.readbyqxmd.com/read/29398998/postoperative-myocardial-injury-and-inflammation-is-not-blunted-by-a-trial-of-atorvastatin-in-orthopedic-surgery-patients
#14
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
https://www.readbyqxmd.com/read/29389729/a-narrative-review-of-cardiovascular-abnormalities-after-spontaneous-intracerebral-hemorrhage
#15
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
https://www.readbyqxmd.com/read/29383871/preoperative-platelet-transfusions-to-reverse-antiplatelet-therapy-for-urgent-non-cardiac-surgery-an-observational-cohort-study
#16
M Baschin, S Selleng, A Hummel, S Diedrich, H W Schroeder, T Kohlmann, A Westphal, A Greinacher, T Thiele
Essentials An increasing number of patients requiring surgery receive antiplatelet therapy (APT). We analyzed 181 patients receiving presurgery platelet transfusions to reverse APT. No coronary thrombosis occurred after platelet transfusion. This justifies a prospective trial to test preoperative platelet transfusions to reverse APT. SUMMARY: 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...
April 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29327897/peripheral-arterial-occlusive-disease-and-perioperative-risk
#17
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...
April 2018: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/29285132/effects-of-dexmedetomidine-on-h-fabp-ck-mb-ctni-levels-neurological-function-and-near-term-prognosis-in-patients-undergoing-heart-valve-replacement
#18
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
https://www.readbyqxmd.com/read/29250545/efficacy-and-mechanism-of-preoperative-simvastatin-therapy-on-myocardial-protection-after-extracorporeal-circulation
#19
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/29217241/myocardial-protection-in-mitral-valve-surgery-comparison-between-minimally-invasive-approach-and-standard-sternotomy
#20
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
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