ArticlePloS one2019
Perioperative myocardial injury in revascularized coronary patients who undergo noncardiac surgery.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Long-term major adverse cardiovascular events following myocardial injury after non-cardiac surgery: meta-analysis.BJS open · 2023Pooled it
- Preoperative walking recommendation for non-cardiac surgery patients to reduce the length of hospital stay: a randomized control trial.BMC sports science, medicine & rehabilitation · 2021Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhether high-sensitivity cardiac troponin elevation during the perioperative period is associated with poor clinical outcome in revascularized coronary patients who undergo noncardiac surgery remains unclear. We investigated the effects of perioperative troponin elevation on the long-term clinical outcomes of patients with a history of coronary revascularization.
methodsWe analyzed patients whose pre- or postoperative high-sensitivity cardiac troponin I (hs-cTnI) assay results were available. Patients were divided into two groups according to hs-cTnI levels. The patient groups were analyzed separately according to whether hs-cTnI was assessed preoperatively or postoperatively. The primary outcome was all-cause death during the follow-up period.
resultsMedian follow-up duration was 25 months (interquartile range 11-50). In the propensity-matched analysis, the risk of all-cause death during follow-up was higher in the group with elevated hs-cTnI group than in the normal group (12.7% vs 6.3%; hazard ratio [HR], 2.67; 95% confidential interval [CI], 1.04-6.82; p = 0.04). In the propensity-matched analysis of preoperative hs-cTnI levels, we found no significant difference between the groups in the rate of all-cause death (12.9% vs. 11.9%; HR, 1.06; 95% CI, 0.45-2.50; p = 0.89). In the postoperative propensity-matched analysis, all-cause death was higher in patients with elevated hs-cTnI than in those with normal levels (14.9% vs. 5.9%; HR, 2.80; 95% CI, 1.01-7.77; p = 0.048).
conclusionIn revascularized coronary patients who underwent noncardiac surgery, postoperative (but not preoperative) hs-cTnI elevation was associated with all-cause death during follow-up. Larger datasets are needed to support this finding.
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