[Perioperative Myocardial Ischemia : Current Aspects and Concepts]

Overview

Journal Anaesthesist

Specialty Anesthesiology

Date 2019 Jun 5

PMID 31161296

Citations 1

Authors

B Bein

R Schiewe

J Renner

Affiliations

Soon will be listed here.

Abstract

In the future an increasing number of older patients with significant comorbidities will have to undergo major surgical procedures. Perioperative cardiovascular events account for many major complications and even fatalities. While perioperative myocardial infarction (PMI) is a generally well-known and recognized complication, the less severe myocardial injury after non-cardiac surgery (MINS) has not gained widespread scientific attention until recently; however, two large observational trials (VISION 1 and VISION 2) have shown a significantly increased mortality after MINS with even subtle increases in troponin T being associated with an increased risk of death. This review summarizes the current knowledge pertaining to PMI and MINS and proposes a diagnostic and therapeutic framework for optimally guiding patients at risk through the perioperative period.

Citing Articles

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PMID: 37789149 DOI: 10.1007/s00059-023-05209-y.

References

Botto F, Srinathan S, Pearse R, Biccard B, Rodseth R, Sheth T . Myocardial injury after noncardiac surgery: a large, international, prospective cohort study establishing diagnostic criteria, characteristics, predictors, and 30-day outcomes. Anesthesiology. 2014; 120(3):564-78. DOI: 10.1097/ALN.0000000000000113. View

Salmasi V, Maheshwari K, Yang D, Mascha E, Singh A, Sessler D . Relationship between Intraoperative Hypotension, Defined by Either Reduction from Baseline or Absolute Thresholds, and Acute Kidney and Myocardial Injury after Noncardiac Surgery: A Retrospective Cohort Analysis. Anesthesiology. 2016; 126(1):47-65. DOI: 10.1097/ALN.0000000000001432. View

Li G, Warner M, Lang B, Huang L, Sun L . Epidemiology of anesthesia-related mortality in the United States, 1999-2005. Anesthesiology. 2009; 110(4):759-65. PMC: 2697561. DOI: 10.1097/aln.0b013e31819b5bdc. View

Flinn W, McDaniel M, Yao J, Fahey V, Green D . Antithrombin III deficiency as a reflection of dynamic protein metabolism in patients undergoing vascular reconstruction. J Vasc Surg. 1984; 1(6):888-95. View

Landesberg G, Mosseri M, Zahger D, Wolf Y, Perouansky M, Anner H . Myocardial infarction after vascular surgery: the role of prolonged stress-induced, ST depression-type ischemia. J Am Coll Cardiol. 2001; 37(7):1839-45. DOI: 10.1016/s0735-1097(01)01265-7. View

Lee T, Marcantonio E, Mangione C, Thomas E, Polanczyk C, Cook E . Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999; 100(10):1043-9. DOI: 10.1161/01.cir.100.10.1043. View

Kamel H, Johnston S, Kirkham J, Turner C, Kizer J, Devereux R . Association between major perioperative hemorrhage and stroke or Q-wave myocardial infarction. Circulation. 2012; 126(2):207-12. PMC: 3986632. DOI: 10.1161/CIRCULATIONAHA.112.094326. View

Freda B, Tang W, Van Lente F, Peacock W, Francis G . Cardiac troponins in renal insufficiency: review and clinical implications. J Am Coll Cardiol. 2002; 40(12):2065-71. DOI: 10.1016/s0735-1097(02)02608-6. View

Udelsman R, Norton J, Jelenich S, Goldstein D, Linehan W, Loriaux D . Responses of the hypothalamic-pituitary-adrenal and renin-angiotensin axes and the sympathetic system during controlled surgical and anesthetic stress. J Clin Endocrinol Metab. 1987; 64(5):986-94. DOI: 10.1210/jcem-64-5-986. View

10.

Lienhart A, Auroy Y, Pequignot F, Benhamou D, Warszawski J, Bovet M . Survey of anesthesia-related mortality in France. Anesthesiology. 2006; 105(6):1087-97. DOI: 10.1097/00000542-200612000-00008. View

11.

Rodseth R, Biccard B, Le Manach Y, Sessler D, Lurati Buse G, Thabane L . The prognostic value of pre-operative and post-operative B-type natriuretic peptides in patients undergoing noncardiac surgery: B-type natriuretic peptide and N-terminal fragment of pro-B-type natriuretic peptide: a systematic review and individual.... J Am Coll Cardiol. 2013; 63(2):170-80. DOI: 10.1016/j.jacc.2013.08.1630. View

12.

Klinkenberg L, van Dijk J, Tan F, van Loon L, van Dieijen-Visser M, Meex S . Circulating cardiac troponin T exhibits a diurnal rhythm. J Am Coll Cardiol. 2014; 63(17):1788-95. DOI: 10.1016/j.jacc.2014.01.040. View

13.

Hallermayer K, Klenner D, Vogel R . Use of recombinant human cardiac Troponin T for standardization of third generation Troponin T methods. Scand J Clin Lab Invest Suppl. 1999; 230:128-31. View

14.

. Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries. Br J Anaesth. 2016; 117(5):601-609. PMC: 5091334. DOI: 10.1093/bja/aew316. View

15.

Pearse R, Harrison D, James P, Watson D, Hinds C, Rhodes A . Identification and characterisation of the high-risk surgical population in the United Kingdom. Crit Care. 2006; 10(3):R81. PMC: 1550954. DOI: 10.1186/cc4928. View

16.

Gore M, Seliger S, deFilippi C, Nambi V, Christenson R, Hashim I . Age- and sex-dependent upper reference limits for the high-sensitivity cardiac troponin T assay. J Am Coll Cardiol. 2014; 63(14):1441-8. PMC: 3984900. DOI: 10.1016/j.jacc.2013.12.032. View

17.

Futier E, Lefrant J, Guinot P, Godet T, Lorne E, Cuvillon P . Effect of Individualized vs Standard Blood Pressure Management Strategies on Postoperative Organ Dysfunction Among High-Risk Patients Undergoing Major Surgery: A Randomized Clinical Trial. JAMA. 2017; 318(14):1346-1357. PMC: 5710560. DOI: 10.1001/jama.2017.14172. View

18.

Puelacher C, Lurati Buse G, Seeberger D, Sazgary L, Marbot S, Lampart A . Perioperative Myocardial Injury After Noncardiac Surgery: Incidence, Mortality, and Characterization. Circulation. 2017; 137(12):1221-1232. DOI: 10.1161/CIRCULATIONAHA.117.030114. View

19.

Le Manach Y, Perel A, Coriat P, Godet G, Bertrand M, Riou B . Early and delayed myocardial infarction after abdominal aortic surgery. Anesthesiology. 2005; 102(5):885-91. DOI: 10.1097/00000542-200505000-00004. View

20.

Duceppe E, Parlow J, MacDonald P, Lyons K, McMullen M, Srinathan S . Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery. Can J Cardiol. 2016; 33(1):17-32. DOI: 10.1016/j.cjca.2016.09.008. View