Peri-operative Myocardial Injury in Patients Undergoing Surgery for Critical Limb Ischaemia

Hobbs, Simon; Yapanis, M.; Burns, Philip A.; Wilmink, A; Bradbury, Andrew W.; Adam, Donald J.

doi:10.1016/j.ejvs.2004.11.002

Cited by 42 publications

(41 citation statements)

References 15 publications

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“…1). Fifty-seven studies were excluded, as we were unable to obtain sufficient data and the remaining nine studies, representing seven patient cohorts, were then eligible for analysis [2,[7][8][9][10][11][12][13][14]. An additional cohort was identified [15], resulting in eight cohorts included in the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…When evaluating primary outcomes in the included studies, we found great variability in the endpoints: major adverse cardiac events were reported in two short-term studies [9,13] and in one long-term study [7]; and cardiac death was only reported in one study [13]. Therefore, it was only possible to conduct a meta-analysis of all-cause mortality for asymptomatic troponin elevation not diagnostic of myocardial infarction (Fig.…”

Section: ó 2011 the Authorsmentioning

confidence: 99%

“…2). A troponin level elevated above the normal reference range, but not exceeding the threshold for peri-operative myocardial infarction, was strongly predictive of all-cause Kim et al [14] Intermediate term (6 months) *** * *** Tambyraja et al [9] Short term (30 days) **** * ** Le Manach et al [2] Short term (in hospital) *** * *** Motamed et al [10] Long term (up to 5 years) *** * ** Hobbs et al [13] Intermediate term (6 months) **** * *** Bolliger et al [7] Long term (12 months) **** * *** Rajogopalan et al [11] Short term (in hospital) **** * ** Brizuela Sanz et al [12] Short term (in hospital) *** * ** Biccard and Naidoo [15] Short term (30 days) *** * *** NOS, Newcastle Ottawa Quality Assessment Scale for cohort studies. .…”

Section: ó 2011 the Authorsmentioning

confidence: 99%

“…Five of the studies were associated with an effect estimate higher than the overall effect estimate and two studies were associated with an effect estimate lower than the overall effect estimate. As the study by Hobbs et al did not contribute any peri-operative myocardial infarction data, this study was not included in the funnel plot [13].…”

Section: ó 2011 the Authorsmentioning

confidence: 99%

“…. One study examined in-hospital complications in patients with an isolated troponin leak, but without peri-operative myocardial infarction [13]. This study was removed to show the relationship between 30-day mortality for the studies reporting both an isolated troponin leak and peri-operative myocardial infarction (Figs 3 and 4).…”

Section: ó 2011 the Authorsmentioning

confidence: 99%

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Outcomes in vascular surgical patients with isolated postoperative troponin leak: a meta-analysis

2011

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SummaryAlthough peri-operative myocardial infarction remains a significant cause of morbidity and mortality following vascular surgery, the significance of an isolated troponin leak is uncertain. This is an elevation of troponin below the diagnostic threshold for a peri-operative myocardial infarction, without symptoms or ischaemic electrocardiography changes or echocardiography signs such as new regional wall motion abnormalities. This meta-analysis aimed to determine the early (< 30 days) and intermediate (< 180 days) outcomes of vascular surgical patients with an isolated troponin leak. A full literature search up to December 2010 identified 593 studies, of which nine

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Section: Resultsmentioning

confidence: 99%

Section: ó 2011 the Authorsmentioning

confidence: 99%

Section: ó 2011 the Authorsmentioning

confidence: 99%

Section: ó 2011 the Authorsmentioning

confidence: 99%

Section: ó 2011 the Authorsmentioning

confidence: 99%

See 3 more Smart Citations

Outcomes in vascular surgical patients with isolated postoperative troponin leak: a meta-analysis

2011

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Vaskuläre Rehabilitation

Altmann

Preuss

Schäfer³

et al. 2020

Gefässchirurgie

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Endovascular Revascularization and Outcomes of Critical Limb-Threatening Ischemia in Trinidad and Tobago: The EVENT Pilot Study—Challenges in a Limited-Resource, Caribbean Setting

Harnanan

Parbhu

Pran³

et al. 2023

Cardiol Ther

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Introduction This retrospective study investigated major adverse limb events (MALE) and mortality outcomes in critical limb-threatening ischemia (CLTI) patients with tissue loss after an endovascular revascularization-first (EVR-1st) strategy. Methods MALE and mortality were assessed in 157 consecutive patients with CLTI and tissue loss from June 2019 to June 2022 at the Eric Williams Medical Sciences Complex, Trinidad and Tobago. Results 157 patients underwent the EVR-1st strategy, of whom 20 were pivoted to immediate surgical revascularization (SR). Of the remaining 137 patients, successful EVR was achieved in 112, giving a procedural success of 82% and an all-comer overall success of 71%. The mortality and MALE rates were 2.7% and 8.9% at 2 years, respectively. Males and patients with previous major amputations were at significantly higher risk for MALE ( p values of 0.016 and 0.018, respectively). There was a statistically significant difference in successful EVR for both Rutherford–Baker (RB) 5 (minor) and RB 6 (major) classifications: 63 (56%) vs. 5 (20%) and 49 (44%) vs. 20 (80%), both with a p value of 0.01. There were no differences in successful EVR amongst Wound, Ischemia, Foot Infection (WIfI) clinical stages. There were no differences in successful EVR amongst the Trans-Atlantic Inter-Society Consensus (TASC II) classifications. Conclusions This study may prove clinically informative and applicable for an EVR-1st management strategy for high-risk patients with CLTI in a limited-resource, Caribbean setting. Trial registration number: NCT05547022 (retrospectively registered).

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Peri-operative Myocardial Injury in Patients Undergoing Surgery for Critical Limb Ischaemia

Cited by 42 publications

References 15 publications

Outcomes in vascular surgical patients with isolated postoperative troponin leak: a meta-analysis

Outcomes in vascular surgical patients with isolated postoperative troponin leak: a meta-analysis

Vaskuläre Rehabilitation

Endovascular Revascularization and Outcomes of Critical Limb-Threatening Ischemia in Trinidad and Tobago: The EVENT Pilot Study—Challenges in a Limited-Resource, Caribbean Setting

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