Myocardial Injury After Noncardiac Surgery

Iglesias, Pilar Paniagua; Ruano, Susana Díaz; Álvarez‐García, Jesús

doi:10.1016/j.rec.2014.05.011

Cited by 5 publications

(4 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Si el paciente tenía previamente niveles de troponina elevados, por encima del percentil 99, se considera que el daño miocárdico que acontece es agudo si los niveles de troponina aumentan un 20% o más respecto al basal. Además, hay que tener en cuenta que el daño miocárdico conduce hasta en un 40% de los casos al desarrollo de un IAM perioperatorio (4)(5)(6).…”

Section: Rearunclassified

Lesión miocárdica e infarto agudo de miocardio perioperatorio.

Marta Rodríguez Martín,

Ernesto Rioja Corroto,

Blanca Mateos Pañero

2023

Revista Electrónica AnestesiaR

View full text Add to dashboard Cite

Los pacientes de 45 años o más sometidos a cirugía no cardiaca presentan una mortalidad perioperatoria del 1-2%, siendo la principal causa de fallecimiento las complicaciones cardiovasculares, entre ellas el infarto agudo de miocardio (IAM). Clásicamente, el aumento de los biomarcadores como la troponina ultrasensible (cTn) en el contexto perioperatorio podría haber sido ignorado si esta alteración no se asociaba a clínica isquémica. Actualmente, se define una nueva entidad conocida como “myocardial injury after non-cardiac surgery” (MINS), que presenta aumento de troponinas como biomarcador de daño cardiaco, pero sin síntomas ni evidencia de isquemia miocárdica en un electrocardiograma (ECG). Con el presente artículo, se pretende realizar una revisión de la literatura publicada, tratando de establecer el modo de diferenciar ambas entidades y cómo manejarlas, concluyéndose que el manejo del IAM está más establecido que el manejo del MINS.

show abstract

Section: Rearunclassified

Lesión miocárdica e infarto agudo de miocardio perioperatorio.

Marta Rodríguez Martín,

Ernesto Rioja Corroto,

Blanca Mateos Pañero

2023

Revista Electrónica AnestesiaR

View full text Add to dashboard Cite

show abstract

“…The number of patients with cardiovascular risk factors undergoing non-cardiac surgery is steadily increasing over the last decade 1. Preoperative risk factors, including age over 75 years, coronary heart disease, atrial fibrillation and many more, are associated with a higher risk of postoperative complications 2–4. Myocardial injury after non-cardiac surgery (MINS) is a major cardiovascular complication and occurs in up to 18% of patients over 45 years of age 5.…”

Section: Introductionmentioning

confidence: 99%

“…1 Preoperative risk factors, including age over 75 years, coronary heart disease, atrial fibrillation and many more, are associated with a higher risk of postoperative complications. [2][3][4] Myocardial injury after non-cardiac surgery (MINS) is a major cardiovascular complication and occurs in up to 18% of patients over 45 years of age. 5 Moreover, 4% of patients with MINS will die within 30 days after surgery.…”

Section: Introductionmentioning

confidence: 99%

PerIoperative iNflammatory reSponse assessment In hiGH-risk patienTs undergoing non-cardiac surgery (INSIGHT): study protocol of a prospective non-interventional observational study

et al. 2023

View full text Add to dashboard Cite

IntroductionIncreased inflammatory processes after non-cardiac surgery are very common. The association between postoperative inflammation and the occurrence of cardiovascular complications after non-cardiac surgery are still not entirely clear. Therefore, we will evaluate the association between postoperative inflammation and the occurrence of major cardiovascular complications in patients at-risk for cardiovascular complications undergoing non-cardiac surgery. We will further evaluate the association of postoperative inflammation and days-at-home within 30 days after surgery (DAH30), the incidence of acute kidney injury, postoperative N-terminal probrain natriuretic peptide (NT-proBNP) concentrations and neurocognitive decline.Methods and analysisIn this multicentre study, we will include 1400 patients at-risk for cardiovascular complications undergoing non-cardiac surgery. Our primary aim is to evaluate the association of postoperative maximum C-reactive protein concentration and the occurrence of a composite of five major cardiovascular complications (myocardial infarction, myocardial injury after non-cardiac surgery, new onset of atrial fibrillation, stroke and death) within 30 days after surgery using a Mann-Whitney-U test as well as a logistic regression model. As our secondary aim, we will evaluate the association of a composite of three inflammatory biomarkers (interleukin 6, procalcitonin and copeptin) on the occurrence of our composite of five cardiovascular complications within 30 days and 1 year after surgery, acute kidney injury, DAH30and NT-proBNP concentrations using linear or logistic regression models. We will measure inflammatory biomarkers before surgery, and on the first, second, third and fifth postoperative day. We will check medical records and conduct a telephone survey 30 days and 1 year after surgery. We evaluate neurocognitive function, using a Montreal Cognitive Assessment, before and 1 year after surgery.Ethics and disseminationThis study was approved by the ethics committees at the Medical University of Vienna (2458/2020) and at the Medical University of Graz (33-274 ex 20/21).Trial registration numberNCT04753307.

show abstract

“…Patients who do not fulfill the clinical criteria for MI might still sustain a myocardial injury during postoperative period without exhibiting ischemic symptoms or hallmark ECG changes. [ 3 , 4 ] With advances in surgical techniques and anesthesia, elderly population with cardiovascular comorbidities undergoing noncardiac surgery continues to rise, thereby increasing the incidence of perioperative myocardial injury. Myocardial injury after noncardiac surgery (MINS) is a relatively new clinical concept, defined as “prognostically relevant myocardial injury due to ischemia that occurs during or within 30 days after noncardiac surgery.” [ 5 ] In comparison with MI, the diagnostic definition of MINS allows us to capture prognostically relevant myocardial injuries occurring during the perioperative period.…”

Section: Introductionmentioning

confidence: 99%