• Minerva anestesiologica · May 2023

    Observational Study

    Mortality and incidence of cardiovascular events in patients treated with aspirin and statins at one year after myocardial injury in noncardiac surgery: a prospective observational study.

    • Sandra Beltrán de Heredia, Anna Mases, Lluís Recasens, Sergi Sabaté, Maria Núñez, Laia Bosch, Lorena Roman, Mireia Rueda, Elia Alonso, and Lluís Gallart.
    • Department of Anesthesiology and Intensive Care, Parc de Salut Mar, Barcelona, Spain - sbeltrand@psmar.cat.
    • Minerva Anestesiol. 2023 May 1; 89 (5): 415424415-424.

    BackgroundRecommendations on the diagnosis and management of myocardial injury in noncardiac surgery (MINS) show remarkable variability. Mortality reports also vary. We aimed to describe mortality and major adverse cardiovascular and cerebrovascular event (MACCE) rates in patients with silent MINS treated with postoperative aspirin-statin therapy and with cardiology follow-up.MethodsProspective descriptive cohort study of patients aged 45 years or older scheduled for noncardiac surgery with high risk for cardiovascular complications from May 2017 to April 2019. Aspirin-statin therapy and cardiology follow-up were prescribed for patients with silent (asymptomatic) MINS. The primary outcome was one-year mortality in patients with silent MINS, diagnosed by troponin concentration. Secondary outcomes were mortality in MINS patients with perioperative myocardial infarction (PMI) or chronic myocardial injury (CMI) and MACCE.ResultsWe identified 766 eligible patients and enrolled 747. MINS occurred in 166 patients (22.2%); 151 (91%) had silent MINS and 15 (9%) had PMI. Thirty-one patients (4.1%) had CMI. One-year mortality was higher in patients with silent MINS (22.5%) than in patients with no MINS (7.8%) (P<0.001). One-year mortality rates in MINS patients with PMI or CMI were 27 and 19%, respectively. MACCE were more frequent in patients with silent MINS at 30 days and one year (18 and 25%) than in patients with no MINS (6 and 12%, respectively).ConclusionsRates of mortality and MACCE in patients with silent MINS were high despite aspirin-statin therapy and cardiology follow-up. Further prospective research is needed to assess new postoperative care protocols that might effectively improve outcomes.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…