Prognostic value of preoperative left ventricular global longitudinal strain for predicting postoperative myocardial injury and mortality in patients undergoing major non-cardiac surgery (SOLOMON study).
Int J Cardiol
; 378: 151-158, 2023 05 01.
Article
em En
| MEDLINE
| ID: mdl-36863423
ABSTRACT
BACKGROUND:
The usefulness of preoperative measurement of left ventricular global longitudinal strain (LVGLS) for predicting prognosis in patients undergoing non-cardiac surgery has not been evaluated. We analyzed the prognostic value of LVGLS in predicting postoperative 30-day cardiovascular events and myocardial injury after non-cardiac surgery (MINS).METHODS:
This prospective cohort study was conducted in two referral hospitals and included 871 patients who underwent non-cardiac surgery <1 month after preoperative echocardiography. Those with ejection fraction <40%, valvular heart disease, and regional wall motion abnormality were excluded. The co-primary endpoints were the (1) composite incidence of all-cause death, acute coronary syndrome (ACS), and MINS and (2) composite incidence of all-cause death and ACS.RESULTS:
Among the 871 participants enrolled (mean age 72.9 years; female 60.8%), there were 43 cases of the primary endpoint (4.9%) 10 deaths, 3 ACS, and 37 MINS. Participants with impaired LVGLS (≤16.6%) had a higher incidence of the co-primary endpoints (log-rank P < 0.001 and 0.015) than those without. The result was similar after adjustment with clinical variables and preoperative troponin T levels (hazard ratio = 1.30, 95% confidence interval [CI] = 1.03-1.65; P = 0.027). In sequential Cox analysis and net reclassification index, LVGLS had an incremental value for predicting the co-primary endpoints after non-cardiac surgery. Among the 538 (61.8%) participants who underwent serial troponin assay, LVGLS predicted MINS independently from the traditional risk factors (odds ratio = 3.54, 95% CI = 1.70-7.36; P = 0.001).CONCLUSIONS:
Preoperative LVGLS has an independent and incremental prognostic value in predicting early postoperative cardiovascular events and MINS. CLINICAL TRIAL REGISTRATION URL https//trialsearch.who.int/. Unique identifiers KCT0005147.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doenças Cardiovasculares
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Deformação Longitudinal Global
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
Idioma:
En
Revista:
Int J Cardiol
Ano de publicação:
2023
Tipo de documento:
Article