Post-operative high sensitivity troponin T (hsTnT): toward an extending use for diagnosis and management of myocardial injury after noncardiac surgery?

Chapalain, Xavier; Huet, Olivier

doi:10.21037/jtd.2017.06.146

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…[1] Myocardial injury after non-cardiac surgery (MINS) is a silent event that occurs within 30 days after non-cardiac surgery. [13,14] It is thought to be a stress-induced ischaemia resulting from a myocardial oxygen supply and demand mismatch. [15,16] Unfortunately up to 80% of these MIs are underdiagnosed, [17,18] as the classic symptoms such as chest pain may be atypical or even absent.…”

Section: Researchmentioning

confidence: 99%

“…A therapeutic decision based on hs-cTnT needs to be considered carefully, as therapy could be harmful and increase the risk of bleeding. [14] The MANAGE study evaluated the impact of anticoagulation on perioperative vascular complications after MINS, and provisional results indicate improved outcomes. [48] The POISE study ascertained that beta-blockers were useful in haemodynamically stable patients, but did not rule out the risk of stroke, hypotension, bradycardia and death.…”

Section: Researchmentioning

confidence: 99%

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Prevalence of a postoperative troponin leak in patients with cardiac risk factors undergoing knee and hip arthroplasty in a South African population

2020

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Section: Researchmentioning

confidence: 99%

Section: Researchmentioning

confidence: 99%

Prevalence of a postoperative troponin leak in patients with cardiac risk factors undergoing knee and hip arthroplasty in a South African population

2020

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Ivabradine in the Prevention, and Reduction in Size, of Perioperative Myocardial Injury in Patients Undergoing Orthopedic Surgery for Acute Fracture

Rafiudeen,

Barlis,

Hau

et al. 2023

JAHA

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Background Perioperative myocardial injury is common after major noncardiac surgery and is associated with adverse outcomes. This study investigated the use of ivabradine in patients undergoing urgent surgery for fracture. Methods and Results This was a prospective, double‐blind, placebo‐controlled, randomized clinical trial. Participants were enrolled 1:1 into ivabradine or placebo arm, and study drug was commenced before operation and continued for 7 days or until discharge. High‐sensitivity troponin I was measured daily using Abbott Alinity analyzer and assay, and heart rate data were obtained using continuous Holter monitoring. A total of 199 patients underwent acute orthopedic surgery, 98 in the ivabradine group and 101 in the placebo group. The mean age was 78.7 years (range, 77.5–79.9 years), with 68% women. The average heart rate was 5 to 11 beats per minute lower in the ivabradine group compared with the placebo group at all time points ( P <0.001 for all). There was no statistically significant difference between the ivabradine and placebo groups in the number of patients who had perioperative myocardial injury: 28.6% versus 31.6% ( P =0.71). In patients with perioperative myocardial injury, average peak troponin was 168.8 ng/L (±431.2 ng/L) in the ivabradine group and 2094.5 ng/L (±7201.9 ng/L) in the placebo group ( P =0.16). There was no statistically significant difference between groups in 30‐day mortality, blood pressure, stroke, or major adverse cardiovascular event. Conclusions Starting ivabradine preoperatively in elderly patients requiring acute surgery for fracture did not result in a statistically significant difference in the incidence of perioperative myocardial injury. There was no statistically significant difference in morbidity, mortality, or adverse events between treatment groups. Registration URL: https://www.anzctr.org.au/ ; Unique identifier: ACTRN12616001634460p.

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Post-operative high sensitivity troponin T (hsTnT): toward an extending use for diagnosis and management of myocardial injury after noncardiac surgery?

Cited by 2 publications

References 21 publications

Prevalence of a postoperative troponin leak in patients with cardiac risk factors undergoing knee and hip arthroplasty in a South African population

Prevalence of a postoperative troponin leak in patients with cardiac risk factors undergoing knee and hip arthroplasty in a South African population

Ivabradine in the Prevention, and Reduction in Size, of Perioperative Myocardial Injury in Patients Undergoing Orthopedic Surgery for Acute Fracture

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