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- Title
Perioperative Myocardial Injury and Hemostasis in Patients Undergoing Endovascular Aneurysm Repair for Asymptomatic Infrarenal Abdominal Aortic Aneurysm.
- Authors
Davies, Robert S. M.; Abdelhamid, Mohamed; Vohra, Rajiv K.; Bradbury, Andrew W.; Adam, Donald J.
- Abstract
Objective: (1) To report the incidence of myocardial injury in patients undergoing endovascular aortic aneurysm repair (EVAR) through the routine measurement of perioperative cardiac troponin-T (cTnT) and (2) to investigate and correlate changes in perioperative cTnT levels with any concomitant hemostatic derangement. Methods: Prospective study of 30 patients undergoing elective EVAR for infrarenal abdominal aortic aneurysm. Cardiac TnT was assayed at 24 hours postoperatively. Plasma thrombin antithrombin III complex (TAT), plasminogen activator inhibitor 1 (PAI-1), tissue plasminogen activator (t-PA) activity, and soluble P-selectin (sP-selectin) were assayed preoperatively and at 24 hours postoperatively. Results: Five (17%) patients demonstrated elevated cTnT levels at 24 hours; 3 patients had no clinical evidence of myocardial injury. There was a positive correlation between cTnT and TAT levels at 24 hours post-EVAR (r = .38, P = .039, Kendall-tau B = 0.26). Conclusions: Endovascular aortic aneurysm repair is associated with a significant risk of perioperative myocardial injury that is underdetected clinically and associated with a procoagulopathic state.
- Subjects
UNITED Kingdom; MYOCARDIUM; ABDOMINAL aortic aneurysms; FIBRINOLYTIC agents; ANTIGENS; ELECTROCARDIOGRAPHY; FIBRINOLYSIS; FISHER exact test; HEMOSTASIS; LONGITUDINAL method; PLASMINOGEN activators; STATISTICS; OPERATIVE surgery; THROMBIN; U-statistics; DATA analysis; DATA analysis software; TROPONIN; CHEMICAL inhibitors; WOUNDS &; injuries
- Publication
Vascular & Endovascular Surgery, 2011, Vol 45, Issue 8, p712
- ISSN
1538-5744
- Publication type
Article
- DOI
10.1177/1538574411415124