Abstract

Patients developing perioperative myocardial infarction/injury (PMI) have a high mortality. PMI work-up and therapy remain poorly defined. This prospective multicenter study included high-risk patients undergoing major non-cardiac surgery within a systematic PMI screening and clinical response program. The frequency of cardiovascular imaging during PMI work-up and its yield for possible type 1 myocardial infarction (T1MI) was assessed. Automated PMI detection triggered evaluation by the treating physician/cardiologist, who determined selection/timing of cardiovascular imaging. T1M1 was considered with the presence of a new wall motion abnormality within 30 days in transthoracic echocardiography (TTE), a new scar or ischemia within 90 days in myocardial perfusion imaging (MPI), and Ambrose-Type II or complex lesions within 7 days of PMI in coronary angiography (CA). In patients with PMI, 21% (268/1269) underwent at least one cardiac imaging modality. TTE was used in 13% (163/1269), MPI in 3% (37/1269), and CA in 5% (68/1269). Cardiology consultation was associated with higher use of cardiovascular imaging (27% versus 13%). Signs indicative of T1MI were found in 8% of TTE, 46% of MPI, and 63% of CA. Most patients with PMI did not undergo any cardiovascular imaging within their PMI work-up. If performed, MPI and CA showed high yield for signs indicative of T1MI.

Trial registration:https://clinicaltrials.gov/ct2/show/NCT02573532.

Details

Title
Cardiovascular imaging following perioperative myocardial infarction/injury
Author
Ketina, Arslani 1 ; Gualandro, Danielle M 2 ; Puelacher Christian 3 ; Lurati Buse Giovanna 4 ; Lampart, Andreas 5 ; Bolliger, Daniel 5 ; Schulthess, David 1 ; Glarner Noemi 1 ; Hidvegi Reka 6 ; Kindler Christoph 7 ; Blum, Steffen 1 ; Cardozo Francisco A M 8 ; Caramelli, Bruno 8 ; Lorenz, Gürke 9 ; Wolff, Thomas 9 ; Mujagic Edin 9 ; Schaeren Stefan 10 ; Rikli, Daniel 11 ; Campos, Carlos A 8 ; Fahrni Gregor 1 ; Kaufmann, Beat A 1 ; Haaf, Philip 1 ; Zellweger, Michael J 1 ; Kaiser, Christoph 1 ; Osswald, Stefan 1 ; Steiner, Luzius A 5 ; Mueller, Christian 1 ; Gueckel Johanna 1 ; Liffert Marcel 12 ; Kanhouche Gabriel 8 ; Sazgary Lorraine 1 ; Yu, Pai C 8 ; Prepoudis Alexandra 3 ; Shrestha Samyut 3 ; Lopez-Ayala, Pedro 1 ; Freese, Michael 1 ; Mitrovic, Sandra 13 ; Rentsch Katharina 13 ; Hammerer-Lerchner Angelika 14 

 University of Basel, Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland (GRID:grid.6612.3) (ISNI:0000 0004 1937 0642) 
 University of Basel, Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland (GRID:grid.6612.3) (ISNI:0000 0004 1937 0642); Universidade de São Paulo, Unidade de Medicina Interdisciplinar em Cardiologia, Instituto do Coração, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, São Paulo, Brazil (GRID:grid.11899.38) (ISNI:0000 0004 1937 0722) 
 University of Basel, Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland (GRID:grid.6612.3) (ISNI:0000 0004 1937 0642); University of Basel, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland (GRID:grid.6612.3) (ISNI:0000 0004 1937 0642) 
 University Hospital Düsseldorf, Department of Anaesthesiology, Düsseldorf, Germany (GRID:grid.14778.3d) (ISNI:0000 0000 8922 7789); University Basel, Department of Anaesthesiology, University Hospital Basel, Basel, Switzerland (GRID:grid.6612.3) (ISNI:0000 0004 1937 0642) 
 University Basel, Department of Anaesthesiology, University Hospital Basel, Basel, Switzerland (GRID:grid.6612.3) (ISNI:0000 0004 1937 0642) 
 University of Basel, Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland (GRID:grid.6612.3) (ISNI:0000 0004 1937 0642); Kantonsspital St. Gallen, Department of Anaesthesiology, St. Gallen, Switzerland (GRID:grid.413349.8) (ISNI:0000 0001 2294 4705) 
 Kantonsspital Aarau, Department of Anaesthesiology, Aarau, Switzerland (GRID:grid.413357.7) (ISNI:0000 0000 8704 3732) 
 Universidade de São Paulo, Unidade de Medicina Interdisciplinar em Cardiologia, Instituto do Coração, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, São Paulo, Brazil (GRID:grid.11899.38) (ISNI:0000 0004 1937 0722) 
 University of Basel, Department of Vascular Surgery, University Hospital Basel, Basel, Switzerland (GRID:grid.6612.3) (ISNI:0000 0004 1937 0642) 
10  University of Basel, Department of Spinal Surgery, University Hospital Basel, Basel, Switzerland (GRID:grid.6612.3) (ISNI:0000 0004 1937 0642) 
11  University Hospital Basel, University of Basel, Department Orthopedic Surgery, Basel, Switzerland (GRID:grid.6612.3) (ISNI:0000 0004 1937 0642) 
12  University of Basel, Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland (GRID:grid.6612.3) (ISNI:0000 0004 1937 0642); University Basel, Department of Anaesthesiology, University Hospital Basel, Basel, Switzerland (GRID:grid.6612.3) (ISNI:0000 0004 1937 0642) 
13  University Hospital Basel, Department of Laboratory Medicine, Basel, Switzerland (GRID:grid.410567.1) 
14  Kantonsspital Aarau, Department of Laboratory Medicine, Aarau, Switzerland (GRID:grid.413357.7) (ISNI:0000 0000 8704 3732) 
Publication year
2022
Publication date
2022
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2639130290
Copyright
© The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.