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Troponin myocardial ischaemia post operative

Jacek Górka, Kamil Polok, Jakub Fronczek, Karolina Górka, Mateusz Kózka, Paweł Iwaszczuk, Marzena Frołow, P J Devereaux, Bruce Biccard, Jacek Musiał, Wojciech Szczeklik
OBJECTIVE/BACKGROUND: Venous thromboembolism (VTE) has been considered the dominant major life threatening vascular complication after non-cardiac surgery, but recent studies have shifted the emphasis toward myocardial injury after non-cardiac surgery (MINS) as a common adverse event in the peri-operative setting. The aim of the present study was to compare the incidence and influence on mortality of two dominant venous and arterial events in the peri-operative period by prospectively screening a consecutive cohort of patients undergoing vascular surgery...
March 23, 2018: European Journal of Vascular and Endovascular Surgery
Qingping Wu, Tingting Wang, Shiqiang Chen, Quanjun Zhou, Haobo Li, Na Hu, Yinglu Feng, Nianguo Dong, Shanglong Yao, Zhengyuan Xia
Aims: Remote ischaemic preconditioning (RIPC) by inducing brief ischaemia in distant tissues protects the heart against myocardial ischaemia-reperfusion injury (IRI) in children undergoing open-heart surgery, although its effectiveness in adults with comorbidities is controversial. The effectiveness and mechanism of RIPC with respect to myocardial IRI in children with tetralogy of Fallot (ToF), a severe cyanotic congenital cardiac disease, undergoing open heart surgery are unclear. We hypothesized that RIPC can confer cardioprotection in children undergoing ToF repair surgery...
March 21, 2018: European Heart Journal
Donagh Healy, Mary Clarke-Moloney, Brendan Gaughan, Siobhan O'Daly, Derek Hausenloy, Faisal Sharif, John Newell, Martin O'Donnell, Pierce Grace, John F Forbes, Walter Cullen, Eamon Kavanagh, Paul Burke, Simon Cross, Joseph Dowdall, Morgan McMonagle, Greg Fulton, Brian J Manning, Elrasheid A H Kheirelseid, Austin Leahy, Daragh Moneley, Peter Naughton, Emily Boyle, Seamus McHugh, Prakash Madhaven, Sean O'Neill, Zenia Martin, Donal Courtney, Muhammed Tubassam, Sherif Sultan, Damian McCartan, Mekki Medani, Stewart Walsh
BACKGROUND: Patients undergoing vascular surgery procedures constitute a 'high-risk' group. Fatal and disabling perioperative complications are common. Complications arise via multiple aetiological pathways. This mechanistic redundancy limits techniques to reduce complications that target individual mechanisms, for example, anti-platelet agents. Remote ischaemic preconditioning (RIPC) induces a protective phenotype in at-risk tissue, conferring protection against ischaemia-reperfusion injury regardless of the trigger...
April 23, 2015: Trials
E Kottenberg, M Thielmann, P Kleinbongard, U H Frey, T Heine, H Jakob, G Heusch, J Peters
BACKGROUND: Remote ischaemic pre-conditioning attenuates myocardial injury. Because sulphonylurea drugs interfere with ischaemic and anaesthetic pre-conditioning, we assessed whether remote ischaemic pre-conditioning effects are altered in sulphonylurea-treated diabetics. METHODS: Using the database of our ongoing randomised, placebo-controlled study ( NCT01406678), we assessed the troponin I concentration area under curve (measurements: baseline, 1, 6, 12, 24, 48, and 72 h post-operatively) in sulphonylurea-treated diabetics (n = 27) and non-diabetics (n = 230) without and with remote ischaemic pre-conditioning (three 5-min periods of left upper arm ischaemia with 5-min reperfusion each) during isoflurane anaesthesia before two- to three-vessel coronary artery surgery...
April 2014: Acta Anaesthesiologica Scandinavica
Carol P Chong, William J van Gaal, Judy Savige, Wen Kwang Lim
BACKGROUND: Cardiac injury after orthopaedic surgery is an increasing problem particularly in an ageing population. The detection of cardiac injury has been aided by the use of cardiac troponins which has also raised questions about the utility of this enzyme in the post-operative setting. OBJECTIVE: This review evaluates the diagnosis and pathophysiology of myocardial infarction after orthopaedic surgery and examines how myocardial injury is detected, with particular emphasis on the role of troponin testing...
September 2011: Injury
J Y Lee, C J Kim, M Y Chung
This study investigated the effects of high-dose vitamin C on oxygen free radical production and cardiac enzymes after tourniquet application and ischaemia-reperfusion injury during bilateral total knee replacement (TKR) in elderly patients. In the vitamin C (VC) group (VC group, n = 16), during surgery, patients received a priming bolus of 0.06 g/kg vitamin C with 100 ml saline followed by 0.02 g/kg vitamin C mixed with 30 ml saline, intravenously. The control group (n = 16) received no intra-operative vitamin C...
July 2010: Journal of International Medical Research
B M Biccard, R N Rodseth
It is generally believed that plaque rupture and myocardial oxygen supply-demand imbalance contribute approximately equally to the burden of peri-operative myocardial infarction. This review critically analyses data of post-mortem, pre-operative coronary angiography, troponin surveillance, other pre-operative non-invasive investigations, and peri-operative haemodynamic predictors of myocardial ischaemia and/or myocardial infarction. The current evidence suggests that myocardial oxygen supply-demand imbalance predominates in the early postoperative period...
July 2010: Anaesthesia
Ruifang Liu, Jialin Xing, Na Miao, Weiran Li, Wei Liu, Yong-Qiang Lai, Yi Luo, Bingyang Ji
BACKGROUND: Although adenosine (ADO) has been shown to have beneficial effects against tissue injury after myocardial ischaemia, the controversy still remains regarding the optimal timing, dose, temperature, method of ADO administration and duration of exposure to the drug. This study investigates the cardioprotective effect of exogenous ADO pretreatment as an adjunct to 1 mmol l(-1) ADO cold (12 degrees C) blood cardioplegia during heart valve replacement surgery. MATERIALS AND METHODS: Thirty patients with rheumatic heart valve disease undergoing heart valve replacement operations were randomly assigned to two groups: group C (n=15) and group A (n=15)...
December 2009: European Journal of Cardio-thoracic Surgery
Eftihia Sbarouni, Panagiota Georgiadou, Demosthenes Panagiotakos, Petros A Alivizatos, Vassilis Voudris
BACKGROUND: Any increase of cardiac biomarkers after coronary artery bypass grafting (CABG) indicates myocyte necrosis and is likely to be related to an impaired outcome. We investigated whether ischaemia-modified albumin (IMA), a biomarker of ischaemia, is also raised following CABG. METHODS: We studied 50 stable consecutive patients undergoing elective isolated CABG on cardiopulmonary bypass, of whom 46 were men and four women, aged 64 +/- 9 years. Blood samples were obtained the day before the operation (pre-op) as well as immediately after the operation, 24 h postoperatively (post-op) and the fourth day post-op and assayed for creatine kinase, the MB isoenzyme of creatine kinase, cardiac troponin-I, albumin and IMA...
February 2009: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
M C Barry, J M Hendriks, L C van Dijk, P Pattynama, D Poldermans, D Bouchier Hayes, H van Urk, M R H M van Sambeek
BACKGROUND: Major aortic surgery results in significant haemodynamic and oxidative stress to the myocardium. Cytokine release is a major factor in causing cardiac injury during aortic surgery. Endovascular aortic aneurysm repair (EVAR) has the potential to reduce the severity of the ischaemia reperfusion syndrome and its systemic consequences. AIM: The aim of this study was to investigate the occurrence of myocardial injury during conventional and endovascular abdominal aortic aneurysm repair using measurement of the myocardial-specific protein, cardiac troponin T...
March 2010: Irish Journal of Medical Science
D Mocini, P Muso, E Guendouz, L De Marco, L Mele, R Cini, P Sordini, A Alois, A Costantino, S Arima, C Gentili, M Santini
Erythropoietin (EPO) exerts a tissue-protective activity in several non-haematopoietic tissues such as heart, brain, spinal cord and muscle. We evaluated the relationship between pre-operative endogenous EPO blood levels and myocardial damage in patients undergoing cardiopulmonary bypass (CPB). Furthermore, we investigated whether pre-operative administration of a single bolus of 40,000 IU epoetin alpha (EPOalpha) would reduce troponin I or creatine kinase isoenzyme (CK-MB) after on-pump coronary artery bypass graft (CABG) surgery...
May 2008: Perfusion
Norzeihan Jan Bappu, Panangipalli Venugopal, Akhshay Kumar Bisoi, Pankaj S Mankad
Cerebral hypoperfusion during cardiopulmonary bypass surgery has been thought to be a factor in the aetiology of brain damage with evidence of post-operative neurological deficits. Cardiac-specific biomarkers such as troponin-I, troponin-T and CK-MB have been used extensively to predict myocardial injury and ischaemia. This prospective study investigated the level of troponin-I release in both off-pump and CPB-technique CABG surgery, as well as postulated a relationship of troponin release and post-operative neurological outcome...
July 2006: McGill Journal of Medicine: MJM: An International Forum for the Advancement of Medical Sciences By Students
I Karu, R Loit, K Zilmer, C Kairane, A Paapstel, M Zilmer, J Starkopf
BACKGROUND: In experimental studies, exposure to hyperoxia for a limited time before ischaemia induces a low-grade systemic oxidative stress and evokes an (ischaemic) preconditioning-like effect of the myocardium. We hypothesised that hyperoxia before cardioplegia could protect the myocardium against necrosis and stunning caused by ischaemia-reperfusion. METHODS: Forty patients undergoing coronary artery bypass grafting were randomly exposed to an oxygen fraction of 0...
November 2007: Acta Anaesthesiologica Scandinavica
P M Jogia, M Kalkoff, J W Sleigh, A Bertinelli, M La Pine, A M Richards, G Devlin
The primary objective of this study was to determine the pattern of N-Terminal pro brain natriuretic peptide (NT-pro BNP) secretion pre and post cardiac surgery and then to investigate the correlation between levels of serum NT-pro BNP and postoperative clinical and biochemical endpoints. This was a prospective observational study performed at a tertiary centre in New Zealand, examining 118 adult patients undergoing cardiac surgery. Interventions included blood samples for NT-pro BNP and troponin-T taken 48 hours prior to operation and 12, 36 and 72 hours postoperatively...
June 2007: Anaesthesia and Intensive Care
Rupert M Pearse, Deborah Dawson, Jayne Fawcett, Andrew Rhodes, R Michael Grounds, David Bennett
BACKGROUND: Studies suggest that Goal Directed Therapy (GDT) results in improved outcome following major surgery. However, there is concern that pre-emptive use of inotropic therapy may lead to an increased incidence of myocardial ischaemia and infarction. METHODS: Post hoc analysis of data collected prospectively during a randomised controlled trial of the effects of post-operative GDT in high-risk general surgical patients. Serum troponin T concentrations were measured at baseline and on day 1 and day 2 following surgery...
2007: BMC Cardiovascular Disorders
S C Gibson, A Marsh, C Berry, C Payne, D S Byrne, P N Rogers, A J McKay, H Dargie, D B Kingsmore
OBJECTIVES: The objective of this study was to ascertain the benefit of routine pre-operative cardiac troponin I (cTnI) measurement in patients undergoing major lower extremity amputation for critical limb ischaemia. DESIGN: This was a prospective, blinded observational study. METHODS: All patients scheduled for lower extremity amputation, without evidence of unstable coronary artery disease were recruited prospectively over a period of 1 year...
June 2006: European Journal of Vascular and Endovascular Surgery
S D Hobbs, M Yapanis, P J Burns, A B Wilmink, A W Bradbury, D J Adam
INTRODUCTION: Although up to a half of patients undergoing abdominal aortic aneurysm (AAA) repair suffer myocardial injury, as indicated by a rise in cardiac troponin I (cTnI), this is infrequently accompanied by a rise in creatine kinase (CK)-MB fraction or electrocardiogram (ECG) changes. This study compares for the first time peri-operative cTnI, CK-MB and ECG changes in patients undergoing surgery for critical lower limb ischaemia (CLI). METHODS: Twenty-nine patients (20 men, median age 75 [range, 57-95] years) were studied prospectively...
March 2005: European Journal of Vascular and Endovascular Surgery
Franklin L Rosenfeldt, Salvatore Pepe, Anthony Linnane, Phillip Nagley, Michael Rowland, Ruchong Ou, Silvana Marasco, William Lyon
UNLABELLED: With ageing of the general population, increasing numbers of elderly patients are presenting for interventional cardiac treatment such as cardiac surgery, angioplasty and thrombolysis. However, the results of these interventions in the elderly are inferior to those in the young. A likely contributing factor is an age-related reduction in cellular energy production in the myocardium during interventions that induce aerobic or ischaemic stress. Coenzyme Q10 (CoQ10) has the potential to improve the efficiency of energy production in mitochondria by bypassing defective components in the respiratory chain as well as reducing the effects of oxidative stress...
2002: Biogerontology
M Bäcklund, M Lepäntalo, L Toivonen, M Tuominen, P Tarkkil, P Pere, M Scheinin, L Lindgren
Forty patients (> 65 years) undergoing hip arthroplasty or peripheral vascular surgery both associated with high risk for post-operative myocardial ischaemia were randomized to receive either spinal or general anaesthesia. Ambulatory ECG recording (Holter) until the third post-operative morning, a daily 12-lead ECG and serum creatine kinase and troponine concentraItions were obtained. The number of ischaemic episodes, total duration of ischaemia and ischaemic minutes per hour were noted for each patient peri-operatively...
December 1999: European Journal of Anaesthesiology
P Vijay, L Szekely, T X Aufiero, T G Sharp
Human adrenomedullin (ADM), a peptide comprising 52 amino acids, is a circulating hormone with vasodilator properties. We have evaluated its release by the heart following ischaemic myocardial damage, as indicated by elevated levels of the cardiospecific protein troponin-T (Tn-T) during cardiopulmonary bypass. ADM (pg/ml) and Tn-T (ng/ml) were measured in coronary sinus blood before and after aortic cross-clamp and in venous blood 6 h after surgery in 22 coronary-bypass patients. Based on the pre- and post-clamp Tn-T levels in the coronary sinus, the patients were divided into group I (no change; n=10) and group II (two times increase; n=12)...
April 1999: Clinical Science (1979-)
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