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Prognostic value of perioperative high sensitivity troponin in patients undergoing hip and knee arthroplasty.
Souza, Fábio de; Barbato, Kelly Biancardini Gomes; Ferreira, Viviani Barreira Marangoni; Gualandro, Danielle Menosi; Caramelli, Bruno.
Afiliação
  • Souza F; Department of Internal Medicine, Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad, Rio de Janeiro, RJ, Brazil; Cardiology Discipline, Departamento de Medicina Especializada (DEMESP), Escola de Medicina e Cirurgia, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro,
  • Barbato KBG; Department of Internal Medicine, Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad, Rio de Janeiro, RJ, Brazil.
  • Ferreira VBM; Divisão de Ensino e Pesquisa Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad, Rio de Janeiro, RJ, Brazil.
  • Gualandro DM; Cardiology Department and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
  • Caramelli B; Interdisciplinary Medicine in Cardiology Unit, Cardiology Department, Instituto do Coração (InCor), Hospital das Clínicas da Universidade de São Paulo, São Paulo, SP, Brazil. Electronic address: bcaramel@usp.br.
Clinics (Sao Paulo) ; 79: 100342, 2024.
Article em En | MEDLINE | ID: mdl-38484585
ABSTRACT
The authors conducted a prospective observational study to investigate the prognostic value of high-sensitivity Troponin I (hs-TnI) in the short- and long-term periods after orthopedic surgery, including Total Hip and Knee Arthroplasty (THA and TKA, respectively), in a tertiary orthopedic center in Brazil. Perioperative Myocardial Injury (PMI) was defined as an absolute increase in hs-TnI of ≥ 26 ng/L above preoperative values. The primary endpoint was all-cause mortality assessed at 30 days and 18 months after surgery. The secondary endpoint consisted of a composite

outcome:

cardiovascular death, acute myocardial infarction, angina requiring revascularization, and/or stroke. The authors compared Relative Risks (RR) of all-cause mortality and composite outcomes in patients with or without PMI at 30 days and 18 months. A Cox proportional hazards model for long-term outcomes was calculated and adjusted for age > 70 years, gender, and Revised Cardiac Risk Index (RCRI) class ≥ 2. PMI occurred in 3.4 % of all surgeries. At 30-days, 6.6 % of patients with PMI had died versus none without PMI. At 18 months, 20.0 % of PMI versus 4.7 % without PMI had died (RR = 5.0; 95 % Confidence Interval [95 % CI 1.3-19.3]). Based on composite outcomes in short and long-term periods, the RRs were 16.2 (95 % CI 2.7-96.5) and 7.7 (95 % CI 2.2-26.6), respectively. PMI was associated with all-cause mortality after 18 months and increased risk for a composite outcome (Hazard Ratio [HR = 3.97], 95 % CI 1.13-13.89 and HR = 5.80, 95 % CI 1.93-17.45, respectively). Patients with PMI who underwent THA or TKA presented worse short- and long-term prognoses compared to those without PMI.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artroplastia do Joelho / Infarto do Miocárdio Limite: Aged / Female / Humans / Male Idioma: En Revista: Clinics (Sao Paulo) Assunto da revista: MEDICINA Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artroplastia do Joelho / Infarto do Miocárdio Limite: Aged / Female / Humans / Male Idioma: En Revista: Clinics (Sao Paulo) Assunto da revista: MEDICINA Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos