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Post operative troponin

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
A I Macfarlane, D Rudd, E Knight, L A G Marshman, E P Guazzo, D S Anderson
: Prior studies have suggested that elevated serum Troponin-I (TnI) levels immediately after non-cardiac surgical procedures (8-40%) represent subclinical cardiac stress which independently predicts increased 30-day mortality. Routine post-operative TnI monitoring has therefore been suggested as a standard of care. However, no prior studies have focussed on elective degenerative spine surgery, whilst few have measured pre-op TnI. Further, prolonged prone positioning could represent an additional, independent, cardiac stress...
October 1, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Marija Bozhinovska, Gordana Taleska, Andrej Fabian, Maja Šoštarič
The postoperative low cardiac output is one of the most important complications following cardiac surgery and is associated with increased morbidity and mortality. The condition requires inotropic support to achieve adequate hemodynamic status and tissue perfusion. While catecholamines are utilised as a standard therapy in cardiac surgery, their use is limited due to increased oxygen consumption. Levosimendan is calcium sensitising inodilatator expressing positive inotropic effect by binding with cardiac troponin C without increasing oxygen demand...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
Tsung-Yu Tsai, Feng-Chun Tsai, Pei-Chun Fan, Chih-Hsiang Chang, Chan-Yu Lin, Wei-Wen Chang, Shen-Yang Lee, Hsiang-Hao Hsu, Ya-Chung Tian, Ji-Tseng Fang, Chih-Wei Yang, Yung-Chang Chen
Patients on extracorporeal membrane oxygenation (ECMO) usually have high mortality rate and poor outcome. Age, Creatinine, and Left Ventricular Ejection Fraction (ACEF) score is an easy-calculating score and provides good performance on mortality prediction in patients undergoing cardiac operations or percutaneous coronary intervention, but it has not been applied to patients on ECMO before. In this study, we aimed to use ACEF score obtained within 1 week of ECMO support for in-hospital mortality prediction in patients on ECMO due to severe myocardial failure...
September 1, 2016: Artificial Organs
Renato Braulio, Marcelo Dias Sanches, Antonio Lúcio Teixeira Junior, Paulo Henrique Nogueira Costa, Maria da Consolação Vieira Moreira, Monaliza Angela Rocha, Silvio Amadeu de Andrade, Cláudio Léo Gelape
INTRODUCTION: Primary graft dysfunction is a major cause of mortality after heart transplantation. OBJECTIVE: To evaluate correlations between donor-related clinical/biochemical markers and the occurrence of primary graft dysfunction/clinical outcomes of recipients within 30 days of transplant. METHODS: The prospective study involved 43 donor/recipient pairs. Data collected from donors included demographic and echocardiographic information, noradrenaline administration rates and concentrations of soluble tumor necrosis factor receptors (sTNFR1 and sTNFR2), interleukins (IL-6 and IL-10), monocyte chemoattractant protein-1, C-reactive protein and cardiac troponin I...
April 2016: Brazilian Journal of Cardiovascular Surgery
Ujjwal Kumar Chowdhury, Avneesh Sheil, Poonam Malhotra Kapoor, Rajiv Narang, Parag Gharde, Vishwas Malik, Mani Kalaivani, Arindam Chaudhury
OBJECTIVES: To investigate the release pattern of different cardiac metabolites and biomarkers directly from the coronary sinus (CS) and to establish the diagnostic discrimination limits of each marker protein and metabolites to evaluate perioperative myocardial injury in patients undergoing cardiac surgery under cardiopulmonary bypass (CPB). PATIENTS AND METHODS: Sixty-eight patients undergoing first mitral and/or aortic valve replacements with/without coronary artery bypass grafting and Bentall procedure under CPB and blood cardioplegic arrest were studied...
July 2016: Annals of Cardiac Anaesthesia
Sara Sabatasso, Patrice Mangin, Tony Fracasso, Milena Moretti, Mylène Docquier, Valentin Djonov
The post-mortem diagnosis of acute myocardial ischemia remains a challenge for both clinical and forensic pathologists. We performed an experimental study (ligation of left anterior descending coronary artery in rats) in order to identify early markers of myocardial ischemia, to further apply to forensic and clinical pathology in cases of sudden cardiac death. Using immunohistochemistry, Western blots, and gene expression analyses, we investigated a number of markers, selected among those which are currently used in emergency departments to diagnose myocardial infarction and those which are under investigation in basic research and autopsy pathology studies on cardiovascular diseases...
September 2016: International Journal of Legal Medicine
Khalid I Amber, Najah R Hadi, Bashaer M Muhammad-Baqir, Dina A Jamil, Hayder A Al-Aubaidy
BACKGROUND: This study aims to investigate the inflammatory response in Novolimus bioresorbable coronary scaffold implantation after a course treatment with trimetazidine (35mg tablet/twice daily for 4days). METHODS: This was a randomized single blind study. Forty diabetic patients with critical coronary stenosis were subjected to elective coronary scaffold implantation in Al-Najaf Center for Cardiac Surgery and Trans-Catheter Therapy, Najaf, Iraq, between January and July 2015...
October 1, 2016: International Journal of Cardiology
M Verdoia, A Schaffer, L Barbieri, G Di Giovine, G Bellomo, P Marino, H Suryapranata, G De Luca
BACKGROUND: Pro-thrombotic conditions importantly influence myocardial perfusion and procedural results after percutaneous coronary intervention (PCI). The neutrophil-to-lymphocyte ratio (NLR) has emerged as a predictor of cardiovascular events and of long-term prognosis, especially in ST-elevation myocardial infarction patients undergoing primary PCI. The aim of our study was to evaluate the role of NLR on periprocedural myocardial infarction (MI) in patients undergoing non-urgent PCI...
July 2016: Netherlands Heart Journal
Alina Hua, Holly Pattenden, Maria Leung, Simon Davies, David A George, Hilgardt Raubenheimer, Zakiyah Niwaz, Eric Lim
BACKGROUND: Myocardial injury after non-cardiac surgery (MINS) is defined as troponin elevation of ≥0.03 ng/mL associated with 3.87-fold increase in early mortality. We sought to determine the impact of cardiology intervention on mortality in patients who developed MINS after general thoracic surgery. METHODS: A retrospective review was performed in patients over 5 years. Troponin was routinely measured and levels ≥0.04 ng/mL classified as positive. Data acquisition and mortality status was obtained via medical records and NHS tracing systems...
May 2016: Journal of Thoracic Disease
Roland Faigle, Elisabeth B Marsh, Rafael H Llinas, Victor C Urrutia, Rebecca F Gottesman
INTRODUCTION: Stroke patients undergoing intravenous thrombolysis (IVT) are at increased risk for critical care interventions and mortality. Cardiac troponin elevation is common in stroke patients; however, its prognostic significance is unclear. The present study evaluates troponin elevation as a predictor of critical care needs and mortality in post-IVT patients and describes racial differences in its predictive accuracy. METHODS: Logistic regression and receiver operating characteristics (ROC) analysis were used to determine racial differences in the predictive accuracy of troponin elevation for critical care needs and mortality in post-IVT patients...
April 2016: Journal of Critical Care
R B Grobben, J E P Vrijenhoek, H M Nathoe, H M Den Ruijter, J A R van Waes, L M Peelen, W A van Klei, G J de Borst
OBJECTIVE: Myocardial infarction (MI) is a frequent complication of carotid endarterectomy (CEA), yet most events are silent. Routine post-operative monitoring of cardiac troponin was implemented to facilitate timely recognition of MI and stratify high risk patients. The aim was to evaluate the incidence of troponin elevation after CEA and its association with adverse cardiovascular events. METHODS: This analysis included patients ≥60 years old who underwent CEA, whose troponin-I levels were routinely monitored post-operatively and were included in a cohort study that assessed clinical outcomes...
April 2016: European Journal of Vascular and Endovascular Surgery
Zhong-Qian Lu, Jian-Xia Lu, Yi-Jun Deng
Sepsis is a serious infection-related complication that, in causing significant inflammation, often leads to myocardial injury. Severe inflammation, including in sepsis, is sometimes treated with exogenous glucocorticoids (GCs). Here, to explore the potential effect of GCs to protect against myocardial injury, we created a model of sepsis in rats by performing cecal ligation and puncture (CLP) in 96 rats randomly divided into sham-operated control (N=32), untreated sepsis (CLP, N=32), and GC-treated sepsis (N=32) groups...
2015: International Journal of Clinical and Experimental Medicine
Luciana Andrea Avena Smeili, Paulo Andrade Lotufo
BACKGROUND: Patients undergoing arterial vascular surgery are considered at increased risk for post-operative complications. OBJECTIVE: To assess the incidence and predictors of complications and death, as well as the performance of two models of risk stratification, in vascular surgery. METHODS: This study determined the incidence of cardiovascular complications and deaths within 30 days from surgery in adults. Univariate comparison and logistic regression assessed the risk factors associated with the outcomes, and the receiver operating characteristic (ROC) curve assessed the discriminatory capacity of the revised cardiac risk index (RCRI) and vascular study group of New England cardiac risk index (VSG-CRI)...
November 2015: Arquivos Brasileiros de Cardiologia
Niket Patel, Ricardo Petraco, Erica Dall'Armellina, George Kassimis, Giovanni Luigi De Maria, Sam Dawkins, Regent Lee, Bernard D Prendergast, Robin P Choudhury, John C Forfar, Keith M Channon, Justin Davies, Adrian P Banning, Rajesh K Kharbanda
OBJECTIVES: The aim of this study was to define which measure of microvascular best predicts the extent of left ventricular (LV) infarction. BACKGROUND: Microvascular injury after ST-segment elevation myocardial infarction (STEMI) is an important determinant of outcome. Several invasive measures of the microcirculation at primary percutaneous coronary intervention (PPCI) have been described. One such measure is zero-flow pressure (Pzf), the calculated pressure at which coronary flow would cease...
September 2015: JACC. Cardiovascular Interventions
Kathryn R Crowder, Tristan D Jones, Eddy S Lang, Dongmei M Wang, Steven M Clark, Grant D Innes, James D McMeekin, Michelle M Graham, Andrew D McRae
OBJECTIVE: High-sensitivity troponin T (hs-TnT) assays detect myocardial injury sooner, possibly improving throughput times for emergency department (ED) assessment of suspected acute myocardial infarction (AMI). This study evaluates the influence of hs-TnT implementation on ED length of stay (LOS), consultations and admissions, as well as ED revisits with cardiology admissions for patients undergoing testing for suspected AMI. METHODS: This control pre-post design analysis included patients evaluated using hs-TnT or conventional troponin T...
December 2015: American Journal of Emergency Medicine
Karol Wierzbicki, Maciej Bochenek, Anna Kędziora, Krzysztof Sojecki, Dorota Ciołczyk-Wierzbicka, Piotr Węgrzyn, Rafał Drwiła, Bogusław Kapelak, Irena Milaniak, Jerzy Sadowski
INTRODUCTION: Plasma troponin I (TnI) concentration is a well-established and widely-used marker of myocardial damage. AIM: To determine the correlation between TnI concentration measured within the first 4 days following heart transplantation (HTX) and clinical course, with consideration of hemodynamic performance. MATERIAL AND METHODS: The retrospective study included 54 patients (12-62 years) who underwent HTX. TnI levels were assessed over the first 4 post-operative days...
September 2014: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Emel Fatma Kocak, Cengiz Kocak, Ahmet Aksoy, Ozden Ozben Isiklar, Raziye Akcilar, Ibrahim Fevzi Ozdomanic, Cevher Unsal, Merve Celenk, Irfan Altuntas
AIM: To determine whether there is a correlation between cardiac markers and peri-operative myocardial injury (PMI) and apoptosis in coronary artery bypass graft (CABG) surgery and to compare the efficacy of cardiac markers to detect PMI. METHODS: The study population consisted of 37 patients (24 male, 13 female, mean age 63.4 ± 8.9 years) undergoing elective CABG. Arterial and coronary sinus blood samples were collected just before aortic cross-clamping (pre-ACC) and after aortic declamping (post-ACC)...
November 2015: Cardiovascular Journal of Africa
John M Bonvini, Beatrice Beck-Schimmer, Sonja J Kuhn, Sereina M Graber, Thomas A Neff, Martin Schläpfer
INTRODUCTION: In a recent randomized controlled trial our group has demonstrated in 102 patients that late post-conditioning with sevoflurane performed in the intensive care unit after surgery involving extracorporeal circulation reduced damage to cardiomyocytes exposed to ischemia reperfusion injury. On the first post-operative day the sevoflurane patients presented with lower troponin T values when compared with those undergoing propofol sedation. In order to assess possible clinical relevant long-term implications in patients enrolled in this study, we performed the current retrospective analysis focusing on cardiac and non-cardiac events during the first 6 months after surgery...
2015: PloS One
P Desgranges, H Kobeiter, S Katsahian, M Bouffi, P Gouny, J-P Favre, J M Alsac, J Sobocinski, P Julia, Y Alimi, E Steinmetz, S Haulon, P Alric, L Canaud, Y Castier, E Jean-Baptiste, R Hassen-Khodja, P Lermusiaux, P Feugier, L Destrieux-Garnier, A Charles-Nelson, J Marzelle, M Majewski, A Bourmaud, J-P Becquemin
OBJECTIVES/BACKGROUND: ECAR (Endovasculaire ou Chirurgie dans les Anévrysmes aorto-iliaques Rompus) is a prospective multicentre randomized controlled trial including consecutive patients with ruptured aorto-iliac aneurysms (rAIA) eligible for treatment by either endovascular (EVAR) or open surgical repair (OSR). Inclusion criteria were hemodynamic stability and computed tomography scan demonstrating aorto-iliac rupture. METHODS: Randomization was done by week, synchronously in all centers...
September 2015: European Journal of Vascular and Endovascular Surgery
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