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Evaluation of high- sensitive troponin elevation and cardiovascular events after vascular surgery

Abstract

Patients submitted to arterial vascular surgery have high risk of cardiovascular complications after surgery. Isolated elevations of conventional troponin I and T after vascular surgery are associated to worse short and long term prognosis. Prognostic value of elevated high sensitive troponin after surgery is still uncertain, once there are no studies that evaluated these newer kits of troponin. Objective: to evaluate the behaviour of high sensitive troponins after vascular surgery and its relation to cardiovascular events after vascular surgery. Methods: 232 patients undergoing arterial vascular surgery will be included. All patients must sign the informed consent term approved by the ethics committee. Patients who have cardiovascular events before the arterial surgery will be excluded. All patients will be submitted to cardiac evaluation before surgery following the II guidelines of perioperative evaluation of the Brazilian Society of Cardiology. High-sensitive troponin T (Roche) is the standard kit of the Clinics Hospital Central laboratory and it is obtained in all patients before surgery and once daily for 3 days after surgery. A daily electrocardiogram is also obtained. As a part of the Project it will be performed two kinds of troponin I from Abbott -Architect (ARCHITECT STAT Troponin-I® and ARCHITECT STAT High Sensitive Troponin I®) and troponin I from Siemens at the Heart Institute central laboratory before surgery, , 6 to 12 hours after surgery and once daily for 3 days after surgery. Patients will be followed-up during hospital stay and for 1 year after surgery and occurrence of cardiovascular events will be reported. Primary endpoint will be general mortality and myocardial infarction in 30 days after surgery. Secondary endpoints will be unstable angina, 2o or 3rd degree atrioventricular block, arrhythmias, acute heart failure, cardiac arrest, ischemic stroke and cardiovascular mortality. Patients with and without troponin elevations will be compared . Besides that, ROC curves for all troponin kits will be constructed to find the best cut-off value for cardiovascular events prediction. The areas under the curve for all the kits will be compared. (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)
BUSE, GIOVANNA A. L. LURATI; PUELACHER, CHRISTIAN; GUALANDRO, DANIELLE MENOSI; KILINC, DERYA; GLARNER, NOEMI; HIDVEGI, REKA; BOLLIGER, DANIEL; ARSLANI, KETINA; LAMPART, ANDREAS; STEINER, LUZIUS A.; et al. Adherence to the European Society of Cardiology/European Society of Anaesthesiology recommendations on preoperative cardiac testing and association with positive results and cardiac events: a cohort study. BRITISH JOURNAL OF ANAESTHESIA, v. 127, n. 3, p. 376-385, . (15/23731-6)
PUELACHER, CHRISTIAN; GUALANDRO, DANIELLE M.; BUSE, GIOVANNA LURATI; BOLLIGER, DANIEL; MARBOT, STELLA; KINDLER, CHRISTOPH; HAMMERER-LERCHER, ANGELIKA; GURKE, LORENZ; STEINER, LUZIUS; MUELLER, CHRISTIAN. Etiology of Peri-Operative Myocardial Infarction/Injury After Noncardiac Surgery and Associated Outcome. Journal of the American College of Cardiology, v. 76, n. 16, p. 1910-1912, . (15/23731-6)
BUSE, GIOVANNA A. L. LURATI; PUELACHER, CHRISTIAN; GUALANDRO, DANIELLE MENOSI; GENINI, ALESSANDRO S.; HIDVEGI, REKA; BOLLIGER, DANIEL; ARSLANI, KETINA; STEINER, LUZIUS A.; KINDLER, CHRISTOPH; MUELLER, CHRISTIAN; et al. Association between self-reported functional capacity and major adverse cardiac events in patients at elevated risk undergoing noncardiac surgery: a prospective diagnostic cohort study. BRITISH JOURNAL OF ANAESTHESIA, v. 126, n. 1, p. 102-110, . (15/23731-6)
GUALANDRO, DANIELLE M.; PUELACHER, CHRISTIAN; LURATI BUSE, GIOVANNA; GLARNER, NOEMI; CARDOZO, FRANCISCO A.; VOGT, RONJA; HIDVEGI, REKA; STRUNZ, CELIA; BOLLIGER, DANIEL; GUECKEL, JOHANNA; et al. Incidence and outcomes of perioperative myocardial infarction/injury diagnosed by high-sensitivity cardiac troponin I. Clinical Research in Cardiology, v. 110, n. 9, SI, p. 1450-1463, . (15/23731-6)

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