Revista: | Revista de investigación clínica |
Base de datos: | PERIÓDICA |
Número de sistema: | 000454063 |
ISSN: | 0034-8376 |
Autores: | Millán Figueroa, Alejandro1 López Navarro, Juan M1 Pérez Díaz, Iván1 Galindo Uribe, Jaime2 García Martínez, Blanca1 Villar Velasco, Sonia L. Del3 López Gómez, Tomás3 Zavaleta Martínez, Zamar2 Valladares Pérez, Eduardo J1 Osorio Landa, Hillary K1 Nieto Niño, Andrea G2 Fernández Pellón García, Rodrigo F2 Fagundo Sierra, Reynerio3 |
Instituciones: | 1Instituto Tecnológico y de Estudios Superiores de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ciudad de México. México 2Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Cardiología, Ciudad de México. México 3Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Laboratorio Central, Ciudad de México. México |
Año: | 2020 |
Periodo: | Mar-Abr |
Volumen: | 72 |
Número: | 2 |
Paginación: | 110-118 |
País: | México |
Idioma: | Inglés |
Tipo de documento: | Artículo |
Enfoque: | Analítico, descriptivo |
Resumen en inglés | Background: Various studies suggest that perioperative concentrations of high-sensitivity troponins are incremental and predictive factors of a major adverse cardiac event (MACE) and all-cause mortality. Objective: The objective of the study was to evaluate the predictive value of high-sensitivity cardiac troponin I (hs-cTnI) in the development of MACE and all-cause mortality, within 30-days and 1-year follow-up after noncardiac surgery. Methods: In this prospective cohort study, we included men ≥ 45 years and women ≥ 55 years with ≥ 2 cardiovascular risk factors and undergoing intermediate or high-risk noncardiac surgery. Demographic and clinical information was collected from clinical charts. We measured baseline hs-cTnI 24 h before surgery, and its post-operative concentration 24 h after surgery. Results: In the entire sample, 8 patients (8.6%) developed MACE at 30-days follow-up (4 deaths), 12 (12.9%) within the 1st year (7 deaths), and 17 (18.2%) after complete post-surgical follow-up (10 deaths). We observed higher baseline and post-operative concentrations in patients who presented MACE (12 pg/ml vs. 3.5 pg/ml; p = 0.001 and 18.3 pg/ml vs. 5.45 pg/ml; p = 0.009, respectively). The hazard ratios (HRs) calculated by Cox regression analysis between the hs-cTnI baseline concentration and the post-operative development of MACE at 30-days and 1-year were 5.70 (95% confidence interval [CI], 1.10-29.40) with hs-cTnI > 6.2 pg/ml and 12.86 (95% CI, 1.42-116.34) with hs-cTnI > 3.3 pg/ml, respectively. The estimated post-operative HR death risk at 1-year was 14.43 (95% CI, 1.37-151.61) with hs-cTnI > 4.5 pg/ml. Conclusions: Pre-operative hs-cTnI was an independent predictive risk factor for MACE at 30-days and 1-year after noncardiac surgery and for all-cause mortality at 1-year after noncardiac surgery |
Disciplinas: | Medicina |
Palabras clave: | Cirugía, Sistema cardiovascular, Biomarcadores, Troponina I cardiaca, Eventos adversos, Eventos cardiovasculares, Mortalidad |
Keyword: | Surgery, Cardiovascular system, Biomarkers, Cardiac troponin I, Adverse events, Cardiovascular events, Mortality |
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