Interarm systolic blood pressure difference is associated with myocardial injury after noncardiac surgery

Belen, Erdal; Özal, Ender; Bayyiğit, Akif; Gunaydin, Senay; Helvacı, Ayşen

doi:10.5603/kp.a2016.0008

Cited by 4 publications

(6 citation statements)

References 23 publications

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“…Those factors, even despite the older age of patients are risk factors for perioperative complications in hip replacement. It was recently shown that SBP values in the perioperative period are the good predictor of myocardial injury after surgery [13]. While Figure 3.…”

Section: Discussionmentioning

confidence: 93%

The relationship between the use of cement during total hip replacement and blood pressure values

Łęgosz

Płatek

Kotkowski

et al. 2016

Arterial Hypertension

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Background. Total hip replacement is a common orthopaedic procedure associated with an elevated cardiovascular risk. There are several methods for total hip replacement, including whether or not to use cement for the prosthesis fixation. The aim of the study was to compare clinical characteristics, including blood pressure, in patients undergoing total hip replacement with and without the use of cement. Material and methods. The study included patients with elective total hip replacement surgery, who were divided into those in whom the procedure was performed with or without the use of medical cement. The criteria for using cement were assessed during operation by the operator, according to the current protocol. All patients were interviewed, screened, and had their medical records checked for the prior diagnosis of cardiovascular risk factors. Blood pressure values were measured before and after the procedure according to the current guidelines. Results. The study population consisted of 65 patients in whom the total hip replacement was performed (mean age 61.5 ± 15.0 years; 50.8% male). 60% of patients had the hip replacement without cement and 40.0% had a procedure with the use of cement. Patients in whom the cement was used were significantly older (75.0 ± 8.5 vs. 53.0 ± 11.5 years; p < 0.0001) and more often diagnosed with arterial hypertension (61.5 vs. 33.3%; p = 0.04), than those in whom it was not used. Systolic blood pressure values were significantly higher before and after the procedure (138.8 ± 18.2 vs. 130.8 ± 21.5 mm Hg, p = 0.04; 122.6 ± 13.3 vs. 113.8 ± 14.1 mm Hg, p = 0.03; respectively) in the group which required cement. Conclusions: Patients with hip replacement using cement have higher systolic values before, and after the surgery than in patients in whom cement wasn't used. Therefore careful management and risk assessment is especially important in patients receiving the total hip replacement with the use of cement.

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Section: Discussionmentioning

confidence: 93%

The relationship between the use of cement during total hip replacement and blood pressure values

Łęgosz

Płatek

Kotkowski

et al. 2016

Arterial Hypertension

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“…Sequential measurements have a tendency to overestimate difference compared to simultaneous measurements. Recent studies have confirmed that the IASBPD is closely associated with cardiovascular mortality and peripheral arterial disease [ 9 , 10 ]. The relationship between poor outcome and arterial stiffness in cardiovascular diseases has been demonstrated in different patient populations [ 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…The patients were made to sit for 5 minutes, with feet flat on the ground and back supported before BP measurements were taken. Two separate oscillometric blood pressure (BP) monitors with their own cuffs were used randomly, placed at the appropriate location on the arm and measured by the same trained nurse [ 9 ]. BP devices were validated by European Society of Hypertension (Omron HEM-7001-E; Omron Corp., Tokyo, Japan).…”

Section: Methodsmentioning

confidence: 99%

“…Simultaneous BP measurements were made three times by changing cuff and therefore BP monitor between arms each with 5 minutes interval. The IABPD was defined as the absolute difference between the blood pressure measurements in each arm [ 9 ]. Exaggerated IASBPD was defined as > 10 mmHg difference in systolic blood pressure (SBP) between two arms at all three measurements [ 10 , 11 ].…”

Section: Methodsmentioning

confidence: 99%

“…Mean BP was calculated for both right arm and left arm using all 3 measurements. The difference was noted as the mean absolute IASBPD [ 9 ]. In order to evaluate reproducibility, BP measurements for 50 patients were performed by the same nurse.…”

Section: Methodsmentioning

confidence: 99%

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The Relationship between Inter-Arm Blood Pressure Difference and Coronary Artery Disease Severity Calculated by the SYNTAX Score

Durmuş

Belen

Bayyiğit

et al. 2018

International Journal of Hypertension

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Objectives The inter-arm systolic blood pressure difference (IASBPD) is closely related to cardiovascular mortality and morbidity. The SYNTAX score indicates the extent and complexity of coronary artery disease, which are determined by coronary angiography. The aim of our study is to examine the relationship between the IASBPD (which is easily calculated in routine practice) and the SYNTAX score. Methods 104 patients were included in this cross-sectional study. The IASBPD was calculated by blood pressure measurements obtained simultaneously from both arms. The SYNTAX score was calculated by coronary angiography. Results Patients were divided into two groups: those with a high SYNTAX score (≥20) and those with a low SYNTAX score (<20). The mean IASBPD values were significantly higher in the group with a high SYNTAX score (≥20) (p<0.001). The patients with IASBPD≥10 were more likely to have a high SYNTAX score compared to the patients with IASBPD<10 (p<0.001). Multiple logistic regression analysis revealed that only the IASBPD values were found to be independently associated with high SYNTAX score (OR: 1.717 (CI: 1.307-2.257), p<0.001). Conclusion The IASBPD values obtained by only blood pressure measurements are closely related to the extent of coronary artery disease.

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Prediction of Death After Noncardiac Surgery: Potential Advantage of Using High‐Sensitivity Troponin T as a Continuous Variable

Machado

Rodrigues

Nakazone

et al. 2021

JAHA

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Background Increased high‐sensitivity cardiac troponin T (hs‐cTnT) above the upper reference limit (URL) after noncardiac surgery identifies patients at risk for mortality. Prior studies have not analyzed hs‐cTnT as a continuous variable or probed age‐ and sex‐specific URLs. This study compared the prediction of 30‐day mortality using continuous postoperative hs‐cTnT levels to the use of the overall URL and age‐ and sex‐specific URLs. Methods and Results Patients (876) >40 years of age who underwent noncardiac surgery were included. Hs‐cTnT was measured on postoperative day 1. Cox proportional hazards models were used to compare associations between 30‐day mortality and using hs‐cTnT as a continuous variable, or above the overall or age‐ and sex‐specific URLs. Comparisons were performed by the area under the receiver operating characteristic curve analysis. Mortality was 4.2%. For each 1 ng/L increase in postoperative hs‐cTnT, there was a 0.3% increase in mortality ( P <0.001). Patients with postoperative hs‐cTnT >14 ng/L were 37% of the cohort, while those above age‐ and sex‐specific URLs were 25.3%. Both manifested higher mortality (hazard ratio [HR], 3.19; 95% CI, 1.20–8.49; P =0.020) and (HR, 2.76; P =0.009) than those with normal levels. The area under receiver operating characteristic curve was 0.89 using hs‐cTnT as a continuous variable, 0.87 for age‐ and sex‐specific URLs, and 0.86 for the overall URL. Conclusions Hs‐cTnT as a continuous variable was independently associated with 30‐day mortality and had the highest accuracy. Hs‐cTnT elevations using overall and/or age‐ and sex‐specific URLs were also associated with higher mortality.

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Interarm systolic blood pressure difference is associated with myocardial injury after noncardiac surgery

Cited by 4 publications

References 23 publications

The relationship between the use of cement during total hip replacement and blood pressure values

The relationship between the use of cement during total hip replacement and blood pressure values

The Relationship between Inter-Arm Blood Pressure Difference and Coronary Artery Disease Severity Calculated by the SYNTAX Score

Prediction of Death After Noncardiac Surgery: Potential Advantage of Using High‐Sensitivity Troponin T as a Continuous Variable

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