Frequency of Increase in Cardiac Troponin Levels After Peripheral Arterial Operations (Carotid Endarterectomy, Abdominal Aorta Procedure, Distal Bypass) and Their Effect on Medical Management

Underutilization of antiplatelet and statin therapy after postoperative myocardial infarction following vascular surgery

“…27,28 Future VQI projects may include postoperative troponin surveillance, which has been demonstrated to improve medical management, or addition of high-dose statins in patients at higher risk. 29 Finally, we did not examine other important factors, such as coronary intervention for POMI, and medical treatment, such as control of diabetes and smoking cessation, as they were beyond the scope of our study.…”

Biomarkers in Peripheral Vascular Surgery

“…Sandoval et al evaluated the significance of troponin levels collected before the vascular surgery and daily for the first 72 hours or until discharge. 2 During the study period, serial perioperative troponin measurements were obtained and the peak postoperative troponin value was compared with the preoperative troponin value to derive the delta troponin I. They found that the presence of dynamic serial troponin concentration changes 0.01 mg/L resulted in increased use of antiplatelet agents and uptitration of heart failure therapies and statins in patients DOI of original article: http://dx.doi.org/10.1053/j.jvca.2018.05.042.…”

“…1 We recognize the work of Sandoval et al in examining the influence of postoperative serum troponin levels postoperatively. 2 Other work also has recognized this potential predictive value for cardiac troponins in the vascular surgery population. 3,4 Bolliger et al was able to combine troponin with beta-natriuretic peptide to demonstrate an association with both cardiac morbidity and all-cause mortality.…”

Remote Preconditioning and Vascular Surgery

“…The primary outcome was myocardial injury and we thought that our “all-comers” approach would efficiently test the hypothesis that RIPC can deliver cardioprotection given that there is a high incidence of troponin leakage in our selected population. 22 We also evaluated a composite clinical outcome, which included a range of important individual clinical outcomes, with a view toward accurate sample size estimation for subsequent studies that could be powered for clinical outcomes. Disappointingly, RIPC did not influence myocardial injury, renal injury, or clinical outcomes but, importantly, we demonstrated feasibility of our study design.…”