The Impact of Cardiology Consultation on Medical Intensive Care Unit Patients with Elevated Troponin Levels

Kousa, Omar; Essa, Amr; Saleh, Mohammed; Ahsan, Muhammad Junaid; Alali, Yaman; Pajjuru, Venkata Siva Kumar; Anani, Abedelrahman; Ahmad, Aiza; Baskaran, Janani; Walters, Ryan W.; Sharma, Arindam; Haddad, Toufik Mahfood; Smer, Aiman

doi:10.1016/j.amjms.2020.09.005

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…Anesthesiologist and surgeons may often seek the assistance of a cardiologist to evaluate cardiovascular risk. However, some studies have showed that preoperative cardiology consultation not only provides little advice that impacts perioperative outcome but also increased cardiac testing, the length of stay, and financial burden ( 48 , 49 ). Therefore, the prudent utilization of preoperative consultation and investigations is essential to avoid unnecessary delays in surgery, reduce healthcare costs, and promote cost-effective healthcare delivery.…”

Section: Introductionmentioning

confidence: 99%

Myocardial injury before noncardiac surgery

Chen,

Zhang,

Zeng

et al. 2023

Front. Cardiovasc. Med.

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Non-cardiac surgical procedures present a significant circulatory stress and can potentially trigger cardiovascular events, such as myocardial infarction and heart failure. Myocardial injury before non-cardiac surgery is associated with an increased risk of mortality and major cardiovascular complications during perioperative period, as well as up to 5 years after non-cardiac surgery. While the definition of preoperative myocardial injury is not yet clear, it is generally understood as myocardial injury resulting from various causes of troponin elevation without acute coronary syndrome prior to surgery. Detecting preoperative myocardial injury through routine troponin monitoring is crucial for reducing perioperative risk, but it is also challenging. The aim of this review is to discuss the definition of preoperative myocardial injury, its pathophysiology, implications on clinical practice and decision-making for patients with elevated troponin levels before non-cardiac surgery.

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Section: Introductionmentioning

confidence: 99%

Myocardial injury before noncardiac surgery

Chen,

Zhang,

Zeng

et al. 2023

Front. Cardiovasc. Med.

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Elevated Troponin in Patients With Acute Gastrointestinal Bleeding: prevalence, Predictors and Outcomes

et al. 2022

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Background: Cardiac troponin (cTn) can also be elevated in patients with non-cardiac illnesses. The utility of elevated cTn in patients with acute gastrointestinal bleeding (AGIB) is unclear. Methods: We retrospectively identified all patients admitted with AGIB who had cTn ordered. We assessed the prevalence, predictors and mortality. Results: A total of 172 patients with AGIB were included in the study, of whom 17% had abnormal cTn. Predictors of elevated cTn were advanced age, lower BMI, coronary artery disease and chronic kidney disease. The abnormal cTn group had more cardiac consultation and procedures and longer length of stay. However, there was no difference in mortality between the two groups. Conclusion: Elevated cTn in patients with AGIB was associated with more cardiology consultation and downstream cardiac testing, greater delay to endoscopic evaluation and longer length of stay, without significantly affecting the mortality.

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The Impact of Cardiology Consultation on Medical Intensive Care Unit Patients with Elevated Troponin Levels

Cited by 2 publications

References 12 publications

Myocardial injury before noncardiac surgery

Myocardial injury before noncardiac surgery

Elevated Troponin in Patients With Acute Gastrointestinal Bleeding: prevalence, Predictors and Outcomes

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