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Effect of volatile anesthetics on myocardial infarction after coronary artery surgery: a post hoc analysis of a randomized trial
Zangrillo, Alberto; Lomivorotov, Vladimir V; Pasyuga, Vadim V; Belletti, Alessandro; Gazivoda, Gordana; Monaco, Fabrizio; Neto, Caetano Nigro; Likhvantsev, Valery V; Bradic, Nikola; Lozovskiy, Andrey; Lei, Chong; Bukamal, Nazar A R; Silva, Fernanda Santos; Bautin, Andrey E; Ma, Jun; Yong, Chow Yen; Carollo, Cristiana; Kunstyr, Jan; Wang, Chew Yin; Grigoryev, Evgeny V; Riha, Hynek; Wang, Chengbin; El-Tahan, Mohamed R; Scandroglio, Anna Mara; Mansor, Marzida; Lembo, Rosalba; Ponomarev, Dmitry N; Bezerra, Francisco José Lucena; Ruggeri, Laura; Chernyavskiy, Alexander M; Xu, Junmei; Tarasov, Dmitry G; Navalesi, Paolo; Yavorovskiy, Andrey; Bove, Tiziana; Kuzovlev, Artem; Hajjar, Ludhmila A; Landoni, Giovanni.
Afiliação
  • Zangrillo, Alberto; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute. School of Medicine, Vita-Salute San Raffaele University. Milan. IT
  • Lomivorotov, Vladimir V; Department of Anesthesiology and Intensive Care, Novosibirsk State University. Department of Anesthesiology and Intensive Care, E. Meshalkin National Medical Research Center. Novosibirsk. RU
  • Pasyuga, Vadim V; Federal Center for Cardiovascular Surgery Astrakhan. Department of Anesthesiology and Intensive Care. Astrakhan. RU
  • Belletti, Alessandro; IRCCS San Raffaele Scientific Institute. Department of Anesthesia and Intensive Care. Milan. IT
  • Gazivoda, Gordana; Department of Anaesthesia and Intensive Care, Cardiovascular Institute Dedinje. Belgrade. RS
  • Monaco, Fabrizio; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute. Milan. IT
  • Neto, Caetano Nigro; Dante Pazzanese Institute of Cardiology. Anesthesia Section, Department of Cardiovascular Surgery. São Paulo. BR
  • Likhvantsev, Valery V; Department of Anesthesiology and Intensive Care, First Moscow State Medical University, V. Negovsky Reanimatology Research Institute. Moscow. RU
  • Bradic, Nikola; Department of Cardiovascular Anesthesiology and Intensive Care Medicine, Clinical Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Dubrava. Department of Biomedical Sciences, University North. Varazdin. HR
  • Lozovskiy, Andrey; Department of Anesthesia and Intensive Care, Ural Institute of Cardiology. Ekaterinburg. RU
  • Lei, Chong; Department of Anesthesiology and Perioperative Medicine, Xijing Hospital. Xi'an. CN
  • Bukamal, Nazar A R; Cardiothoracic ICU and Anesthesia Department, Mohammed Bin Khalifa Cardiac Center. Riffa. BH
  • Silva, Fernanda Santos; Department of Anaesthesiology, Hospital de Santa Maria. Lisboa. PT
  • Bautin, Andrey E; Laboratory for Anesthesiology and Intensive Care, Almazov National Medical Research Center. Saint Petersburg. RU
  • Ma, Jun; Center for Anesthesiology, Beijing Anzhen Hospital, Capital Medical University. Beijing. CN
  • Yong, Chow Yen; Department of Anaesthesiology and Intensive Care, Hospital Pulau Pinang. Pinang. MY
  • Carollo, Cristiana; Institute of Anesthesia and Intensive Care, Padua University Hospital. Padua. IT
  • Kunstyr, Jan; Department of Anesthesiology and Intensive Care, First Faculty of Medicine Charles University and General University Hospital. Prague. CZ
  • Wang, Chew Yin; Department of Anaesthesiology, Faculty of Medicine, University of Malaya. Kuala Lumpur. MY
  • Grigoryev, Evgeny V; Intensive Care Unit, Scientific Research Institute for Complex Issues of Cardiovascular Diseases. Kemerovo. RU
  • Riha, Hynek; Cardiothoracic Anesthesiology and Intensive Care Medicine, Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine. Prague. CZ
  • Wang, Chengbin; Center for Anesthesiology, Beijing Anzhen Hospital, Capital Medical University. Beijing. CN
  • El-Tahan, Mohamed R; Department of Anesthesiology, College of Medicine, Imam Abdulrahman Bin Faisal University. Dammam. SA
  • Scandroglio, Anna Mara; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute. Milan. IT
  • Mansor, Marzida; Department of Anaesthesiology, Faculty of Medicine, University of Malaya. Kuala Lumpur. MY
  • Lembo, Rosalba; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute. Milan. IT
  • Ponomarev, Dmitry N; Department of Anesthesiology and Intensive Care, E Meshalkin National Medical Research Center. Novosibirsk. RU
  • Bezerra, Francisco José Lucena; Dante Pazzanese Institute of Cardiology. Anesthesia Section, Department of Cardiovascular Surgery. São Paulo. BR
  • Ruggeri, Laura; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute. Milan. IT
  • Chernyavskiy, Alexander M; Department of Anesthesiology and Intensive Care, E Meshalkin National Medical Research Center. Novosibirsk. RU
  • Xu, Junmei; Department of Anesthesiology, The Second Xiangya Hospital of Central South University. Changsha. CN
  • Tarasov, Dmitry G; Department of Cardiac Surgery, Federal Center for Cardiovascular Surgery Astrakhan. Astrakhan. RU
  • Navalesi, Paolo; Department of Medicine, University of Padua. Institute of Anesthesia and Intensive Care, Padua University Hospital. Padua. IT
  • Yavorovskiy, Andrey; Federal Research and Clinical Center of Resuscitation and Rehabilitation. Moscow. RU
  • Bove, Tiziana; Department of Anesthesia and Intensive Care Medicine, ASUFC University-Hospital of Central Friuli. Department of Medicine (DAME), University of Udine. Udine. IT
  • Kuzovlev, Artem; V Negovsky Reanimatology Research Institute. Moscow. RU
  • Hajjar, Ludhmila A; Universidade de São Paulo. Department of Cardiopneumology, Instituto do Coração. Intensive Care Unit, Hospital Sirio Libanes. São Paulo. BR
  • Landoni, Giovanni; School of Medicine, Vita-Salute San Raffaele University. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute. Milan. IT
J. cardiothoracic vasc. anest ; 36(8,pt.A): 2454-2462, Jan. 2022.
Artigo em Inglês | CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1359687
Biblioteca responsável: BR79.1
ABSTRACT

OBJECTIVE:

To investigate the effect of volatile anesthetics on the rates of postoperative myocardial infarction (MI) and cardiac death after coronary artery bypass graft (CABG).

DESIGN:

A post hoc analysis of a randomized trial.

SETTING:

Cardiac surgical operating rooms.

PARTICIPANTS:

Patients undergoing elective, isolated CABG.

INTERVENTIONS:

Patients were randomized to receive a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or total intravenous anesthesia (TIVA). The primary outcome was hemodynamically relevant MI (MI requiring high-dose inotropic support or prolonged intensive care unit stay) occurring within 48 hours from surgery. The secondary outcome was 1-year death due to cardiac causes. Measurements and main

Results:

A total of 5,400 patients were enrolled between April 2014 and September 2017 (2,709 patients randomized to the volatile anesthetics group and 2,691 to TIVA). The mean age was 62 ± 8.4 years, and the median baseline ejection fraction was 57% (50-67), without differences between the 2 groups. Patients in the volatile group had a lower incidence of MI with hemodynamic complications both in the per-protocol (14 of 2,530 [0.6%] v 27 of 2,501 [1.1%] in the TIVA group; p = 0.038) and as-treated analyses (16 of 2,708 [0.6%] v 29 of 2,617 [1.1%] in the TIVA group; p = 0.039), but not in the intention-to-treat analysis (17 of 2,663 [0.6%] v 28 of 2,667 [1.0%] in the TIVA group; p = 0.10). Overall, deaths due to cardiac causes were lower in the volatile group (23 of 2,685 [0.9%] v 40 of 2,668 [1.5%] than in the TIVA group; p = 0.03).

CONCLUSIONS:

An anesthetic regimen, including volatile agents, may be associated with a lower rate of postoperative MI with hemodynamic complication in patients undergoing CABG. Furthermore, it may reduce long-term cardiac mortality.
Assuntos
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Coleções: Bases de dados nacionais / Brasil Contexto em Saúde: ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis Problema de saúde: Doença Cardiovascular Base de dados: CONASS / Sec. Est. Saúde SP / SESSP-IDPCPROD Assunto principal: Transplantes / Desflurano / Anestesia Intravenosa Tipo de estudo: Ensaio clínico controlado Idioma: Inglês Revista: J. cardiothoracic vasc. anest Ano de publicação: 2022 Tipo de documento: Artigo Instituição/País de afiliação: Cardiothoracic Anesthesiology and Intensive Care Medicine, Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine/CZ / Cardiothoracic ICU and Anesthesia Department, Mohammed Bin Khalifa Cardiac Center/BH / Center for Anesthesiology, Beijing Anzhen Hospital, Capital Medical University/CN / Dante Pazzanese Institute of Cardiology/BR / Department of Anaesthesia and Intensive Care, Cardiovascular Institute Dedinje/RS / Department of Anaesthesiology and Intensive Care, Hospital Pulau Pinang/MY / Department of Anaesthesiology, Faculty of Medicine, University of Malaya/MY / Department of Anaesthesiology, Hospital de Santa Maria/PT / Department of Anesthesia and Intensive Care Medicine, ASUFC University-Hospital of Central Friuli/IT / Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute/IT
Buscar no Google
Coleções: Bases de dados nacionais / Brasil Contexto em Saúde: ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis Problema de saúde: Doença Cardiovascular Base de dados: CONASS / Sec. Est. Saúde SP / SESSP-IDPCPROD Assunto principal: Transplantes / Desflurano / Anestesia Intravenosa Tipo de estudo: Ensaio clínico controlado Idioma: Inglês Revista: J. cardiothoracic vasc. anest Ano de publicação: 2022 Tipo de documento: Artigo Instituição/País de afiliação: Cardiothoracic Anesthesiology and Intensive Care Medicine, Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine/CZ / Cardiothoracic ICU and Anesthesia Department, Mohammed Bin Khalifa Cardiac Center/BH / Center for Anesthesiology, Beijing Anzhen Hospital, Capital Medical University/CN / Dante Pazzanese Institute of Cardiology/BR / Department of Anaesthesia and Intensive Care, Cardiovascular Institute Dedinje/RS / Department of Anaesthesiology and Intensive Care, Hospital Pulau Pinang/MY / Department of Anaesthesiology, Faculty of Medicine, University of Malaya/MY / Department of Anaesthesiology, Hospital de Santa Maria/PT / Department of Anesthesia and Intensive Care Medicine, ASUFC University-Hospital of Central Friuli/IT / Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute/IT
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