PERI-OPERATIVE INJURY AND MYOCARDIAL INFARCTION
https://doi.org/10.21292/2078-5658-2019-16-2-51-56
Abstract
Peri-operative myocardial infarction (MI) is the most severe complication of non-cardiac surgery associated with a high post-operative mortality rate. The main risk factors responsible for the development of this complication include concurrent cardiovascular pathology, as well as intra-operative hypertension and tachycardia. Diagnosis MI in the postoperative period is complicated due to an insignificant pain syndrome because of administration of analgesics and the lack of routine monitoring of troponin levels. Maintaining a balance between myocardial oxygen delivery and consumption is a key factor in the prevention of this complication.
About the Authors
V. V. Lomivorotov
E.N. Meshalkin Research Institute of Blood Circulation Pathology
Russian Federation
Russian Federation
Doctor of Medical Sciences, Professor, Correspondent Member of RAS, Head of Anesthesiology and Intensive Care Center,
15, Rechkunovskaya st., Novosibirsk, 630055
V. N. Lomivorotov
E.N. Meshalkin Research Institute of Blood Circulation Pathology
Russian Federation
Russian Federation
Doctor of Medical Sciences, Professor, Head of Training Center,
15, Rechkunovskaya st., Novosibirsk, 630055
References
1. Vorobiev V.L., Semenikhin А.А., Grachev N.I. et al. The prospective trial of one-year clinical outcomes of using Colipso coronary stent in the patients with acute coronary syndrome. Patologiya Krovoobrascheniya i Kardiokhirurgiya, 2017, vol. 21, no. 1, pp. 44-49. (In Russ.)
2. Lomivorotov V.V., Аbubakirov M.N., Fominskiy E.V. et al. Cardioprotective effects of phosphocreatine Vestnik Anasteziol. i Reanimatol., 2016, vol. 13, no. 5, pp. 74-80. (In Russ.)
3. Amsterdam E.A., Wenger N.K., Brindis R.G. et al. 2014 AHA/ACC Guideline for the Management of Patients with Non-ST-Elevation Acute Coronary Syndromed: a report of the American College of Cardiology. American Heart Association Task Force on Practice Guidelines. J. Am. Coll. Cardiol., 2014, vol. 64, no. 24, pp. 139-228.
4. Bartels K., Karhausen J., Clambey E.T. et al. Perioperative organ injury. Anesthesiology, 2013, vol. 119, no. 6, pp. 1474-1489.
5. Botto F., Alonso-Coello P., Chan M.T. et al. Myocardial injury after noncardiac surgery: a large, international, prospective cohort study establishing diagnostic criteria, characteristics, predictors, and 30-day outcomes. Anesthesiology, 2014, vol. 120, no. 3, pp. 564-578.
6. Devereaux P.J., Biccard B.M., Sigamani A. et al. Association of postoperative high-sensitivity troponin levels with myocardial injury and 30-day mortality among patients undergoing noncardiac surgery. JAMA, 2017, vol. 317, no. 16, pp. 1642-1651.
7. Devereaux P.J., Duceppe E., Guyatt G. et al. Dabigatran in patients with myocardial injury after non-cardiac surgery (MANAGE): an international, randomised, placebo-controlled trial. Lancet, 2018, vol. 391, pp. 2325-2334.
8. Devereaux P.J., Goldman L., Cook D.J. et al. Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk. CMAJ, 2005, vol. 173, no. 6, pp. 627-634.
9. Devereaux P.J., Mrkobrada M., Sessler D.I. et al. Aspirin in patients undergoing noncardiac surgery . N. Engl. J. Med., 2014, vol. 370, no. 16, pp. 1494-1503.
10. Devereaux P.J., Sessler D.I. Cardiac Complications in Patients Undergoing Major Noncardiac Surgery. N. Engl. J. Med., 2015, vol. 373, no. 23, pp. 2258-2269.
11. Devereaux P.J., Sessler D.I., Leslie K. et al. Clonidine in patients undergoing noncardiac surgery. N. Engl. J. Med., 2014, vol. 370, no. 16, pp. 1504-1513.
12. Devereaux P.J., Xavier D., Pogue J. et al. Characteristics and short-term prognosis of perioperative myocardial infarction in patients undergoing noncardiac surgery: a cohort study. Ann. Intern. Med., 2011, vol. 154, no. 8, pp. 523-528.
13. Duceppe E., Parlow J., MacDonald P. et. al. Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery. Can. J. Cardiol., 2017, vol. 33, no. 1, pp. 17-32.
14. Eriksson B.I., Dahl O.E., Rosencher N. et al. Dabigatran etexilate versus enoxaparin for prevention of venous thromboembolism after total hip replacement: a randomised, double-blind, non-inferiority trial. Lancet, 2007, vol. 370, pp. 949-956.
15. Fleisher L.A., Fleischmann K.E., Auerbach A.D. et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J. Am. Coll. Cardiol., 2014, vol. 64, no. 22, pp. e77–e137.
16. Ibanez B., James S., Agewall S. et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur. Heart J., 2018, vol. 39, no. 2, pp. 119-177.
17. International Surgical Outcomes Study Group. Global patient outcomes after elective surgery: prospective cohort study in 27 low, middle and high income countries. Br. J. Anaesth., 2016, vol. 117, no. 5, pp. 601-609.
18. Landoni G., Zangrillo A., Lomivorotov V.V. et al. Cardiac protection with phosphocreatine: a meta-analysis. Interact. Cardiovasc. Thorac. Surg., 2016, vol. 23, no. 4, pp. 637-646.
19. Lee T.H., Marcantonio E.R., Mangione C.M. et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation, 1999, vol. 100, no. 10, pp. 1043-1049.
20. Pearse R.M., Moreno R.P., Bauer P. et al. Mortality after surgery in Europe: a 7 day cohort study. Lancet, 2012, vol. 380, pp. 1059-1065.
21. Sessler D.I. Lost in Translation: The 2016 John W. Severinghaus Lecture on Translational Research. Anesthesiology, 2017, vol. 126, no. 6, pp. 995-1004.
22. Thygesen K., Alpert J.S., Jaffe A.S. et al. Fourth Universal Definition of Myocardial Infarction (2018). J. Am. Coll. Cardiol., 2018, vol. 72, no. 18, pp. 2231-2264.
23. Walsh M., Devereaux P.J., Garg A.X. et al. Relationship between intraoperative mean arterial pressure and clinical outcomes after noncardiac surgery: toward an empirical definition of hypotension. Anesthesiology, 2013, vol. 119, no. 3, pp. 507-515.
Review
For citations:
Lomivorotov V.V., Lomivorotov V.N. PERI-OPERATIVE INJURY AND MYOCARDIAL INFARCTION. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2019;16(2):51-56. (In Russ.) https://doi.org/10.21292/2078-5658-2019-16-2-51-56
Email this article 