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Increase in biomarkers of myocardial necrosis after surgical or percutaneous revascularization in the absence of demonstrated myocardial infarction

Abstract

The detection of elevated cardiac enzyme levels without the occurrence of ECG changes with or without the presence of symptoms after coronary artery bypass grafting with cardiopulmonary bypass (CPB) identifies, by consensus, perioperative myocardial infarction.Because of this, many events of myocardial injury can occur without the ECG is sensitive enough to detect this abnormality. Potential mechanisms of perioperative myocardial necrosis are many and occur mainly by technical conditions or the severity of the patient. This scenario included intermittent clamping of the aorta, with intervention in native coronary artery occlusion or embolism and venous graft.Recent studies have shown that CABG can be performed without the aid of (CPB). Further studies indicate that with this technique, we get better myocardial protection, less cellular and mitochondrial damage, with consequent reduction of cellular necrosis.Additional resources for myocardial revascularization include angioplasty using stent angioplasty. This procedure has also elevated biomarkers of necrosis without ECG changes.Predictors of perioperative myocardial infarction procedure may be related to the quality of the vase, plate or both. Moreover, they may be related to the quality of equipment or instruments. Thus, in order to define the rate of release of enzymes as borderline irreversible damage to consider this study aims to study patients undergoing surgical or percutaneous coronary intervention. (AU)

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Scientific publications (4)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
CARDOSO DE AZEVEDO, DIOGO FREITAS; HUEB, WHADY; LIMA, EDUARDO GOMES; REZENDE, PAULO CURY; LINHARES FILHO, JAIME PAULA PESSOA; DE CARVALHO, GUILHERME FERNANDES; MARTINS, EDUARDO BELLO; NOMURA, CESAR HIGA; CASSARO STRUNZ, CELIA MARIA; SERRANO JUNIOR, CARLOS VICENTE; FRANCHINI RAMIRES, JOSE ANTONIO; KALIL FILHO, ROBERTO. Significant association of SYNTAX score on release of cardiac biomarkers in uncomplicated post-revascularization procedures among patients with stable multivessel disease MASS-V Study group. MEDICINE, v. 99, n. 8 FEB 2020. Web of Science Citations: 0.
COSTA OIKAWA, FERNANDO TEIICHI; HUEB, WHADY; NOMURA, CESAR HIGA; HUEB, ALEXANDRE CIAPPINA; VILLA, ALEXANDRE VOLNEY; ALVES DA COSTA, LEANDRO MENEZES; VIEIRA DE MELO, RODRIGO MOREL; REZENDE, PAULO CURY; WAINROBER SEGRE, CARLOS ALEXANDRE; GARZILLO, CIBELE LARROSA; LIMA, EDUARDO GOMES; FRANCHINI RAMIRES, JOSE ANTONIO; FILHO, ROBERTO KALIL. Abnormal elevation of myocardial necrosis biomarkers after coronary artery bypass grafting without established myocardial infarction assessed by cardiac magnetic resonance. JOURNAL OF CARDIOTHORACIC SURGERY, v. 12, DEC 29 2017. Web of Science Citations: 0.
HUEB, WHADY; GERSH, BERNARD J.; ALVES DA COSTA, LEANDRO MENEZES; COSTA OIKAWA, FERNANDO TEIICHI; VIEIRA DE MELO, RODRIGO MOREL; REZENDE, PAULO CURY; GARZILLO, CIBELE LARROSA; LIMA, EDUARDO GOMES; NOMURA, CESAR HIGA; VILLA, ALEXANDRE VOLNEY; HUEB, ALEXANDRE CIAPPINA; CASSARO STRUNZ, CELIA MARIA; FAVARATO, DESIDERIO; TAKIUTI, MYRTHES EMY; DE ALBUQUERQUE, CICERO PIVA; RIBEIRO DA SILVA, EXPEDITO EUSTAQUIO; FRANCHINI RAMIRES, JOSE ANTONIO; KALIL FILHO, ROBERTO. Accuracy of Myocardial Biomarkers in the Diagnosis of Myocardial Infarction After Revascularization as Assessed by Cardiac Resonance: The Medicine, Angioplasty, Surgery Study V (MASS-V) Trial. Annals of Thoracic Surgery, v. 101, n. 6, p. 2202-2208, JUN 2016. Web of Science Citations: 10.
HUEB, WHADY; GERSH, BERNARD J.; REZENDE, PAULO CURY; GARZILLO, CIBELE LARROSA; LIMA, EDUARDO GOMES; VIEIRA, RICARDO D'OLIVEIRA; RAHMI GARCIA, ROSA MARIA; FAVARATO, DESIDERIO; SEGRE, CARLOS ALEXANDRE W.; PEREIRA, ALEXANDRE COSTA; SOARES, PAULO ROGERIO; RIBEIRO, EXPEDITO; LEMOS, PEDRO; PERIN, MARCO A.; STRUNZ, CELIA CASSARO; DALLAN, LUIS A. O.; JATENE, FABIO B.; STOLF, NOEDIR A. G.; HUEB, ALEXANDRE CIAPPINA; DIAS, RICARDO; GAIOTTO, FABIO A.; ALVES DA COSTA, LEANDRO MENEZES; COSTA OIKAWA, FERNANDO TEIICHI; VIEIRA DE MELO, RODRIGO MOREL; SERRANO JUNIOR, CARLOS VICENTE; RODRIGUES DE AVILA, LUIZ FRANCISCO; VILLA, ALEXANDRE VOLNEY; PARGA FILHO, JOSE RODRIGUES; NOMURA, CESAR; RAMIRES, JOSE A. F.; KALIL FILHO, ROBERTO; GRP, MASS-V STUDY. Hypotheses, rationale, design, and methods for prognostic evaluation of cardiac biomarker elevation after percutaneous and surgical revascularization in the absence of manifest myocardial infarction. A comparative analysis of biomarkers and cardiac magnetic resonance. The MASS-V Trial. BMC CARDIOVASCULAR DISORDERS, v. 12, AUG 16 2012. Web of Science Citations: 5.

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