Identifier to cite or link to this item: https://hdl.handle.net/20.500.13003/18913
Myocardial injury after major non-cardiac surgery evaluated with advanced cardiac imaging: a pilot study
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eISSN: 1471-2261
WOS ID: 000932692900002
Scopus EID: 2-s2.0-85147892766
PMID: 36765313
Embase PUI: L2021407080
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Álvarez-Garcia, Jesús; Popova, Ekaterine; Vives-Borrás, Miquel
Publication date
2023-02-10Document type
research articleCitation
Álvarez-Garcia J, Popova E, Vives-Borrás M, de Nadal M, Ordonez-Llanos J, Rivas-Lasarte M, et al. Myocardial injury after major non-cardiac surgery evaluated with advanced cardiac imaging: a pilot study. BMC Cardiovasc Disord. 2023 Feb;23(1):78.Abstract
Myocardial injury after non-cardiac surgery (MINS) is a frequent complication caused by cardiac and non-cardiac pathophysiological mechanisms, but often it is subclinical. MINS is associated with increased morbidity and mortality, justifying the need to its diagnose and the investigation of their causes for its potential prevention.
Prospective, observational, pilot study, aiming to detect MINS, its relationship with silent coronary artery disease and its effect on future adverse outcomes in patients undergoing major non-cardiac surgery and without postoperative signs or symptoms of myocardial ischemia. MINS was defined by a high-sensitive cardiac troponin T (hs-cTnT) concentration > 14 ng/L at 48-72 h after surgery and exceeding by 50% the preoperative value; controls were the operated patients without MINS. Within 1-month after discharge, cardiac computed tomography angiography (CCTA) and magnetic resonance imaging (MRI) studies were performed in MINS and control subjects. Significant coronary artery disease (CAD) was defined by a CAD-RADS category ≥ 3. The primary outcomes were prevalence of CAD among MINS and controls and incidence of major cardiovascular events (MACE) at 1-year after surgery. Secondary outcomes were the incidence of individual MACE components and mortality.
We included 52 MINS and 12 controls. The small number of included patients could be attributed to the study design complexity and the dates of later follow-ups (amid COVID-19 waves). Significant CAD by CCTA was equally found in 20 MINS and controls (30% vs 33%, respectively). Ischemic patterns (n = 5) and ischemic segments (n = 2) depicted by cardiac MRI were only observed in patients with MINS. One-year MACE were also only observed in MINS patients (15.4%).
This study with advanced imaging methods found a similar CAD frequency in MINS and control patients, but that cardiac ischemic findings by MRI and worse prognosis were only observed in MINS patients. Our results, obtained in a pilot study, suggest the need of further, extended studies that screened systematically MINS and evaluated its relationship with cardiac ischemia and poor outcomes. Trial registration Clinicaltrials.gov identifier: NCT03438448 (19/02/2018).
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https://doi.org/10.1186/s12872-023-03065-6MeSH
Prospective StudiesPilot Projects
Risk Factors
Humans
Postoperative Complications
Coronary Artery Disease
COVID-19
Heart Injuries
Myocardial Ischemia
DeCS
Complicaciones PosoperatoriasLesiones Cardíacas
Isquemia Miocárdica
Factores de Riesgo
Proyectos Piloto
Humanos
Estudios Prospectivos
Enfermedad de la Arteria Coronaria
COVID-19
This item appears in following Docusalut collections
Hospital Universitario Son Espases - HUSE > Comunicación científicaInstituto de Investigación Sanitaria Islas Baleares - IDISBA > Comunicación científica