Postoperative Myocardial Injury and Inflammatory Biomarkers in Patients Undergoing Vascular Surgery: A Subanalysis of the Platelet Reactivity and Postoperative Myocardial Injury after Major Vascular Surgery (PROMISE) Study.

Autor:	Zheng K; Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands., Bor WL; Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands., Kelder JC; Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands., Hackeng CM; Department of Clinical Chemistry, St. Antonius Hospital, Nieuwegein, the Netherlands., Kropman RHJ; Department of Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands., Ten Berg JM; Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands; University Medical Centre Maastricht, Maastricht University, Maastricht, the Netherlands., Noordzij PG; Department of Anaesthesiology, Intensive Care and Pain Medicine, St. Antonius Hospital, Nieuwegein, the Netherlands; Department of Anaesthesiology, Intensive Care and Pain medicine, University Medical Centre, Utrecht, the Netherlands. Electronic address: p.noordzij@antoniusziekenhuis.nl.
Jazyk:	angličtina
Zdroj:	Annals of vascular surgery [Ann Vasc Surg] 2024 May; Vol. 102, pp. 202-208. Date of Electronic Publication: 2023 Nov 04.
DOI:	10.1016/j.avsg.2023.09.092
Abstrakt:	Background: Postoperative myocardial injury (PMI) is associated with morbidity and mortality, but the aetiology remains unclear. We studied whether PMI is associated with perioperative systemic inflammation. The objective is the examination of the relationship between inflammatory biomarkers (Interleukin 6[IL-6], C-reactive protein [CRP]) and PMI, detected by elevated cardiac troponin (cTn), in patients undergoing elective open abdominal aortic surgery. Methods: This prospective, single-center, observational cohort study included 54 patients undergoing elective open abdominal aortic surgery between March 2018 and April 2021. Patients were routinely treated with aspirin. IL-6 and CRP were measured preoperatively, directly after surgery, 24 hr and 48 hr postoperatively. The primary outcome was cTn release assessed by a fifth-generation high-sensitive cTn assay. Multivariable generalized linear regression models were used to evaluate the association between inflammatory biomarkers and cTn concentrations. Results: Fifteen patients (27.8%) developed PMI. IL-6 directly and 24 hr postoperatively was associated with elevated cTn concentrations (1.28 [1.07-1.54], P = 0.009) and 1.75 [1.18-2.59], P = 0.006, respectively). Also, CRP directly and 24 hr postoperatively was associated with elevated cTn concentrations (1.25 [1.06-1.47], P = 0.009) and 1.61 [1.1-2.33], P = 0.013, respectively). No association was found between IL-6 or CRP and cTn concentrations when measured at 48 hr postsurgery. Conclusions: Biomarkers of inflammation are associated with elevated postoperative cTn concentrations in the early postoperative period in patients undergoing elective open abdominal aortic surgery. (Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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