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The Relevance of Implementing the Systematic Screening of Perioperative Myocardial Injury in Noncardiac Surgery Patients.
Popova, Ekaterine; Paniagua-Iglesias, Pilar; Álvarez-García, Jesús; Vives-Borrás, Miquel; González-Osuna, Aránzazu; García-Osuna, Álvaro; Rivas-Lasarte, Mercedes; Hermenegildo-Chavez, Gisela; Diaz-Jover, Ruben; Azparren-Cabezon, Gonzalo; Barceló-Trias, Montserrat; Moustafa, Abdel-Hakim; Aguilar-Lopez, Raul; Ordonez-Llanos, Jordi; Alonso-Coello, Pablo.
Afiliação
  • Popova E; Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain.
  • Paniagua-Iglesias P; Centro Cochrane Iberoamericano, 08025 Barcelona, Spain.
  • Álvarez-García J; Department of Anesthesia and Pain Management, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
  • Vives-Borrás M; Department of Cardiology, Hospital Universitario Ramon y Cajal, 28034 Madrid, Spain.
  • González-Osuna A; Department of Cardiology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
  • García-Osuna Á; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), 29010 Madrid, Spain.
  • Rivas-Lasarte M; Department of Cardiology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
  • Hermenegildo-Chavez G; Department of Cardiology, Fundació Institut d'Investigació Sanitària Illes Balears (IdISBa), 07120 Palma, Spain.
  • Diaz-Jover R; Department of Orthopedic Surgery and Traumatology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
  • Azparren-Cabezon G; Department of Biochemistry, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
  • Barceló-Trias M; Department of Cardiology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
  • Moustafa AH; Department of Cardiology, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Majadahonda, Spain.
  • Aguilar-Lopez R; Department of Anesthesia and Pain Management, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
  • Ordonez-Llanos J; Department of Anesthesia and Pain Management, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
  • Alonso-Coello P; Department of Anesthesia and Pain Management, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
J Clin Med ; 12(16)2023 Aug 18.
Article em En | MEDLINE | ID: mdl-37629413
ABSTRACT
Perioperative myocardial injury (PMI) is a common cardiac complication. Recent guidelines recommend its systematic screening using high-sensitivity cardiac troponin (hs-cTn). However, there is limited evidence of local screening programs. We conducted a prospective, single-center study aimed at assessing the feasibility and outcomes of implementing systematic PMI screening. Hs-cTn concentrations were measured before and after surgery. PMI was defined as a postoperative hs-cTnT of ≥14 ng/L, exceeding the preoperative value by 50%. All patients were followed-up during the hospitalization, at one month and one year after surgery. The primary outcome was the incidence of death and major cardiovascular and cerebrovascular events (MACCE). The secondary outcomes focused on the individual components of MACCE. We included two-thirds of all eligible high-risk patients and achieved almost complete compliance with follow-ups. The prevalence of PMI was 15.7%, suggesting a higher presence of cardiovascular (CV) antecedents, increased perioperative CV complications, and higher preoperative hs-cTnT values. The all-cause death rate was 1.7% in the first month, increasing up to 11.2% at one year. The incidence of MACCE was 9.5% and 8.6% at the same time points. Given the observed elevated frequencies of PMI and MACCE, implementing systematic PMI screening is recommendable, particularly in patients with increased cardiovascular risk. However, it is important to acknowledge that achieving optimal screening implementation comes with various challenges and complexities.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Diagnostic_studies / Risk_factors_studies / Screening_studies Idioma: En Revista: J Clin Med Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Espanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Diagnostic_studies / Risk_factors_studies / Screening_studies Idioma: En Revista: J Clin Med Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Espanha