Perioperative myocardial injury in patients with coronary artery disease during elective lower limb surgery

Autor: Yu. A. Kudaev, A. V. Vorobeva, N. L. Lokhovinina, I. T. Abesadze, M. Z. Alugishvili, I. V. Titenkov, M. A. Chernyavsky, A. V. Panov
Jazyk: English<br />Russian
Rok vydání: 2023
Předmět:
Zdroj: Рациональная фармакотерапия в кардиологии, Vol 19, Iss 5, Pp 444-451 (2023)
Druh dokumentu: article
ISSN: 1819-6446
2225-3653
DOI: 10.20996/1819-6446-2023-2937
Popis: Aim. To assess the prevalence of ischemic myocardial injury and the cardioprotective effect of nicorandil by assessing high-sensitivity cardiac troponin (hs-cTn) in patients with stable coronary artery disease (CAD) during elective lower limb surgery, as well as to identify predictors of adverse cardiac events.Material and methods. The study included 70 patients with stable coronary artery disease hospitalized for elective autogenous femoropopliteal bypass (FPB) surgery. After randomization, all patients were divided into two following groups: control group — 35 patients; main group — 35 patients, who, in addition to standard therapy, were prescribed nicorandil (Cordinic, PIQ-PHARMA) in a single dose of 20 mg 2 hours before surgery. In the postoperative period, the incidence of myocardial injury was assessed by hs-cTn increase. The obtained primary data were subjected to mathematical processing using the R-Studio software package (R language).Results. At baseline, patients in both groups were comparable in clinical characteristics, therapy, and duration of vascular surgery. In the main group of patients receiving nicorandil, a significant decrease in the incidence of perioperative myocardial injury was noted. In 5 patients of the control group, hs-cTn level 24 hours after surgery exceeded the threshold value, which indicated myocardial injury in the early postoperative period. In the nicorandil group, there was no hs-cTn increase (14% vs 0%, p=0,027). Regression analysis identified a predictor of perioperative myocardial injury — left ventricular ejection fraction (LVEF)
Databáze: Directory of Open Access Journals
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