Aging as a risk factor for cardiac surgery: Blunted ischemic‐reperfusion stress response?

Wang, Lin; Ren, Jun

doi:10.1111/jocs.15806

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…During aging, cardiac and non-cardiac organs change their structure and consequently lose crucial functional components such as the glomeruli of the kidney resulting in functional impairments that may well take place insidiously and unnoticed for a long period [ 4 , 5 , 6 , 7 ]. Various causes are discussed.…”

Section: Introductionmentioning

confidence: 99%

What Exactly Makes Age a Risk Factor for an Unfavorable Outcome after Mitral Valve Surgery?

Ostovar

Schröter

Kühnel

et al. 2022

JCM

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Objective: Age has an undeniable impact on perioperative mortality. However, it is not necessarily a predictor of frailty per se, as older patients have different outcomes. To verify specific conditions underlying frailty, we examined demographics, comorbidities, frequency, and distribution of postoperative complications influencing outcomes in a challenging cohort of patients undergoing mitral valve surgery. Methods: The study enrolled 1627 patients who underwent mitral valve surgery. Patients younger than 40 years who had been diagnosed with endocarditis were excluded. Patients were divided into three groups with ages ranging from 40–59 (n = 319), 60–74 (n = 795), and >75 years (n = 513). Baseline, comorbidities, postoperative complications, and mortality were recorded. Results: The older the patients were, the more frequently they suffered from pre- and postoperative renal insufficiency (p < 0.001). The likelihood of postoperative renal failure requiring dialysis was significantly higher with pre-existing renal failure. There was a significant association between postoperative renal insufficiency and the development of postoperative pleural or pericardial effusion (p < 0.001, p = 0.016). A significant decrease in BMI was observed in patients >75 years of age compared to the 60–74 years group (27.3 vs. 28.2 kg/m2, p = 0.007). The development of critical illnesses such as myopathy and neuropathy (CIP/CIM) was age-dependent and increased significantly with age (p = 0.04). Hospitalization duration and mortality also increased significantly with age (p = 0.013, p < 0.001). Conclusions: It appears that elderly patients with advanced renal failure have a significantly higher risk of mortality, postoperative renal failure, need for dialysis, and possibly the development of pleural and pericardial effusions in mitral valve surgery. In addition, more frequent CIP/CIM with concomitant decrease in BMI in the most advanced age group indicate sarcopenia and thus an additional feature of frailty besides renal failure.

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Section: Introductionmentioning

confidence: 99%

What Exactly Makes Age a Risk Factor for an Unfavorable Outcome after Mitral Valve Surgery?

Ostovar

Schröter

Kühnel

et al. 2022

JCM

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“…Our study is consistent with a previous study which demonstrated advanced age is a major risk factor for cardiovascular disease [ 16 ]. The mechanisms probably as follows: firstly, aging reduced mitochondrial content and progressively slower stress response to ischemia, contributing to myocardial injury; secondly, autophagy may decrease in aging myocardium as a cellular protective cycling mechanism, leading to cardiac dysfunction and myocardial injury [ 17 , 18 ]. Lee index was widely applied to identify patients at higher risk for perioperative complications or myocardial injury in patients undergoing non-cardiac surgery [ 13 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors of preoperative myocardial injury in patients with gastrointestinal tumors

Shi-ying

Cheng

et al. 2023

BMC Cardiovasc Disord

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Background Recent studies indicated that the prognosis of patients with gastrointestinal tumors is frequently influenced by its complications, notably myocardial injury. The main object is to investigate the occurrence and risk factors of myocardial injury in patients with gastrointestinal tumor. Methods 1126 patients who received gastrointestinal tumor related surgery from May 2018 to June 2020 in the Sixth Affiliated Hospital of Sun Yat-sen University were retrospectively collected and divided into the non-myocardial injury group and the myocardial injury group (high-sensitive cardiac troponin I (hs-cTnI) ≥ 0.028 ng/ml). The occurrence and risk factors of myocardial injury in patients with gastrointestinal tumor are analyzed. The influence of myocardial injury on the ICU detention time in gastrointestinal tumor patients is also studied. Results In total, 78 (6.93%) patients developed myocardial injuries. Compared with patients in the non-myocardial injury group, patients in the myocardial injury group have a higher prevalence of cardiovascular risk factors (including advanced age and higher smoking ratio), a higher prevalence of comorbidities (such as previous coronary artery disease, hypertension, atrium fibrillation and diabetes), and a higher rate of premedication (such as anticoagulation, β-blocker, Angiotensin-converting enzyme inhibitor/Angiotensin II receptor blocker, and diuretic) (all with P-value < 0.05). In addition, patients in the myocardial injury group also presented with a higher revised cardiac risk index (Lee index), higher neutrophil granulocyte ratio, lower hemoglobin, and higher likelihood of impaired cardiac structure and function (all with P-value < 0.05). There was a trend of statistical significance in the ICU detention time between the myocardial injury group and the non-myocardial injury group (1[1,3] vs. 2[1,10], P = 0.064). In this study, there were 7 patients presented with clinical symptoms in the myocardial injury group (chest discomfort in 4 cases, non-compressive precordial chest pain in 1 case, dyspnea in 2 cases). In the multivariate analysis, advanced age, increased Lee index score, increased neutrophil granulocyte ratio, decreased left ventricular ejection fraction (LVEF), increased interventricular septum were independent risk factors for myocardial injury. Conclusion In conclusion, advanced age, increased Lee index, increased neutrophil granulocyte ratio, decreased left ventricular ejection fraction, and increased ventricular septum were independent risk factors for preoperative myocardial injury in patients with gastrointestinal tumors. The proportion of clinical symptoms in gastrointestinal tumor patients with myocardial injury was low, indicating the necessity to closely monitor the cardiac status of individuals with gastrointestinal tumors.

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Cardiac Protective Effects of Proinflammatory Cytokines during Ischemia-Reperfusion

et al. 2021

Cardiology Plus

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Aging as a risk factor for cardiac surgery: Blunted ischemic‐reperfusion stress response?

Cited by 3 publications

References 17 publications

What Exactly Makes Age a Risk Factor for an Unfavorable Outcome after Mitral Valve Surgery?

What Exactly Makes Age a Risk Factor for an Unfavorable Outcome after Mitral Valve Surgery?

Risk factors of preoperative myocardial injury in patients with gastrointestinal tumors

Cardiac Protective Effects of Proinflammatory Cytokines during Ischemia-Reperfusion

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