Ivabradine in the Prevention, and Reduction in Size, of Perioperative Myocardial Injury in Patients Undergoing Orthopedic Surgery for Acute Fracture

Autor: Rifly Rafiudeen, Peter Barlis, Raphael Hau, Sheran Vasanthakumar, Reginald Ng, Philip Wu, Mark Tacey, Adrian Banning, William van Gaal
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 12, Iss 22 (2023)
Druh dokumentu: article
ISSN: 2047-9980
DOI: 10.1161/JAHA.122.028760
Popis: Background Perioperative myocardial injury is common after major noncardiac surgery and is associated with adverse outcomes. This study investigated the use of ivabradine in patients undergoing urgent surgery for fracture. Methods and Results This was a prospective, double‐blind, placebo‐controlled, randomized clinical trial. Participants were enrolled 1:1 into ivabradine or placebo arm, and study drug was commenced before operation and continued for 7 days or until discharge. High‐sensitivity troponin I was measured daily using Abbott Alinity analyzer and assay, and heart rate data were obtained using continuous Holter monitoring. A total of 199 patients underwent acute orthopedic surgery, 98 in the ivabradine group and 101 in the placebo group. The mean age was 78.7 years (range, 77.5–79.9 years), with 68% women. The average heart rate was 5 to 11 beats per minute lower in the ivabradine group compared with the placebo group at all time points (P
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