Peri-operative copeptin concentrations and their association with myocardial injury after vascular surgery
| Autor: | Christian Mueller, Eckhard Mauermann, Daniel Bolliger, Firmin Kamber, Giovanna Lurati Buse, Esther Seeberger, Lorenz Guerke |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Myocardial Infarction Infarction 030204 cardiovascular system & hematology Chest pain Perioperative Care Cohort Studies 03 medical and health sciences Postoperative Complications 0302 clinical medicine Copeptin Troponin T 030202 anesthesiology Interquartile range Internal medicine medicine Humans Prospective Studies Myocardial infarction Prospective cohort study Aged Aged 80 and over business.industry Glycopeptides Perioperative Middle Aged medicine.disease Anesthesiology and Pain Medicine Cardiology Female Myocardial infarction diagnosis medicine.symptom business Vascular Surgical Procedures Biomarkers |
| Zdroj: | European Journal of Anaesthesiology. 35:682-690 |
| ISSN: | 0265-0215 |
| Popis: | BACKGROUND Copeptin levels in conjunction with cardiac troponin may be used to rule out early myocardial infarction in patients presenting with chest pain. Raised pre-operative copeptin has been shown to be associated with postoperative cardiac events. However, very little is known about the peri-operative time course of copeptin or the feasibility of very early postoperative copeptin measurement to diagnose or rule-out myocardial injury. OBJECTIVES In this preparatory analysis for a larger trial, we sought to examine the time course of peri-operative copeptin and identify the time at which concentrations returned to pre-operative levels. Second, in an explorative analysis, we sought to examine the association of copeptin in general and at various time points with myocardial injury occurring within the first 48 h. DESIGN Preparatory analysis of a prospective, observational cohort study. SETTING Single university centre from February to July 2016. PATIENTS A total of 30 consecutive adults undergoing vascular surgery. INTERVENTION Serial peri-operative copeptin measurements. MAIN OUTCOME MEASURE We measured copeptin concentrations before and immediately after surgery (0 h), then at 2, 4, 6 and 8 h after surgery and on the first and second postoperative day. Postoperative concentrations were compared with pre-operative levels with a Wilcoxon signed-rank test. Second, we explored an association between postoperative copeptin concentrations and myocardial injury by the second postoperative day. Myocardial injury was defined as a 5 ng l increase between pre-operative and postoperative high-sensitivity cardiac troponin T with an absolute peak of at least 20 ng l. RESULTS Immediate postoperative copeptin concentrations (median [interquartile range]) increased nearly eight-fold from pre-operative values (8.5 [3.6 to 13.8] to 64.75 pmol l [29.6 to 258.7]; P |
| Databáze: | OpenAIRE |
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