Incidence of major adverse cardiac events following non-cardiac surgery
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Incidence of major adverse cardiac events following non-cardiac surgery. / Sazgary, Lorraine; Puelacher, Christian; Lurati Buse, Giovanna; Glarner, Noemi; Lampart, Andreas; Bolliger, Daniel; Steiner, Luzius; Gürke, Lorenz; Wolff, Thomas; Mujagic, Edin; Schaeren, Stefan; Lardinois, Didier; Espinola, Jacqueline; Kindler, Christoph; Hammerer-Lercher, Angelika; Strebel, Ivo; Wildi, Karin; Hidvegi, Reka; Gueckel, Johanna; Hollenstein, Christina; Breidthardt, Tobias; Rentsch, Katharina; Buser, Andreas; Gualandro, Danielle M; Mueller, Christian; BASEL-PMI Investigators.
In: EUR HEART J-ACUTE CA, Vol. 10, No. 5, 14.10.2020, p. 550–558.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Incidence of major adverse cardiac events following non-cardiac surgery
AU - Sazgary, Lorraine
AU - Puelacher, Christian
AU - Lurati Buse, Giovanna
AU - Glarner, Noemi
AU - Lampart, Andreas
AU - Bolliger, Daniel
AU - Steiner, Luzius
AU - Gürke, Lorenz
AU - Wolff, Thomas
AU - Mujagic, Edin
AU - Schaeren, Stefan
AU - Lardinois, Didier
AU - Espinola, Jacqueline
AU - Kindler, Christoph
AU - Hammerer-Lercher, Angelika
AU - Strebel, Ivo
AU - Wildi, Karin
AU - Hidvegi, Reka
AU - Gueckel, Johanna
AU - Hollenstein, Christina
AU - Breidthardt, Tobias
AU - Rentsch, Katharina
AU - Buser, Andreas
AU - Gualandro, Danielle M
AU - Mueller, Christian
AU - BASEL-PMI Investigators
AU - Twerenbold, Raphael
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.
PY - 2020/10/14
Y1 - 2020/10/14
N2 - AIMS: Major adverse cardiac events (MACE) triggered by non-cardiac surgery are prognostically important perioperative complications. However, due to often asymptomatic presentation, the incidence and timing of postoperative MACE are incompletely understood.METHODS AND RESULTS: We conducted a prospective observational study implementing a perioperative screening for postoperative MACE [cardiovascular death (CVD), acute heart failure (AHF), haemodynamically relevant arrhythmias, spontaneous myocardial infarction (MI), and perioperative myocardial infarction/injury (PMI)] in patients at increased cardiovascular risk (≥65 years OR ≥45 years with history of cardiovascular disease) undergoing non-cardiac surgery at a tertiary hospital. All patients received serial measurements of cardiac troponin to detect asymptomatic MACE. Among 2265 patients (mean age 73 years, 43.4% women), the incidence of MACE was 15.2% within 30 days, and 20.6% within 365 days. CVD occurred in 1.2% [95% confidence interval (CI) 0.9-1.8] and in 3.7% (95% CI 3.0-4.5), haemodynamically relevant arrhythmias in 1.2% (95% CI 0.9-1.8) and in 2.1% (95% CI 1.6-2.8), AHF in 1.6% (95% CI 1.2-2.2) and in 4.2% (95% CI 3.4-5.1), spontaneous MI in 0.5% (95% CI 0.3-0.9) and in 1.6% (95% CI 1.2-2.2), and PMI in 13.2% (95% CI 11.9-14.7) and in 14.8% (95% CI 13.4-16.4) within 30 days and within 365 days, respectively. The MACE-incidence was increased above presumed baseline rate until Day 135 (95% CI 104-163), indicating a vulnerable period of 3-5 months.CONCLUSION: One out of five high-risk patients undergoing non-cardiac surgery will develop one or more MACE within 365 days. The risk for MACE remains increased for about 5 months after non-cardiac surgery.TRIAL REGISTRATION: https://www.clinicaltrials.gov. Unique identifier: NCT02573532.
AB - AIMS: Major adverse cardiac events (MACE) triggered by non-cardiac surgery are prognostically important perioperative complications. However, due to often asymptomatic presentation, the incidence and timing of postoperative MACE are incompletely understood.METHODS AND RESULTS: We conducted a prospective observational study implementing a perioperative screening for postoperative MACE [cardiovascular death (CVD), acute heart failure (AHF), haemodynamically relevant arrhythmias, spontaneous myocardial infarction (MI), and perioperative myocardial infarction/injury (PMI)] in patients at increased cardiovascular risk (≥65 years OR ≥45 years with history of cardiovascular disease) undergoing non-cardiac surgery at a tertiary hospital. All patients received serial measurements of cardiac troponin to detect asymptomatic MACE. Among 2265 patients (mean age 73 years, 43.4% women), the incidence of MACE was 15.2% within 30 days, and 20.6% within 365 days. CVD occurred in 1.2% [95% confidence interval (CI) 0.9-1.8] and in 3.7% (95% CI 3.0-4.5), haemodynamically relevant arrhythmias in 1.2% (95% CI 0.9-1.8) and in 2.1% (95% CI 1.6-2.8), AHF in 1.6% (95% CI 1.2-2.2) and in 4.2% (95% CI 3.4-5.1), spontaneous MI in 0.5% (95% CI 0.3-0.9) and in 1.6% (95% CI 1.2-2.2), and PMI in 13.2% (95% CI 11.9-14.7) and in 14.8% (95% CI 13.4-16.4) within 30 days and within 365 days, respectively. The MACE-incidence was increased above presumed baseline rate until Day 135 (95% CI 104-163), indicating a vulnerable period of 3-5 months.CONCLUSION: One out of five high-risk patients undergoing non-cardiac surgery will develop one or more MACE within 365 days. The risk for MACE remains increased for about 5 months after non-cardiac surgery.TRIAL REGISTRATION: https://www.clinicaltrials.gov. Unique identifier: NCT02573532.
U2 - 10.1093/ehjacc/zuaa008
DO - 10.1093/ehjacc/zuaa008
M3 - SCORING: Journal article
C2 - 33620378
VL - 10
SP - 550
EP - 558
JO - EUR HEART J-ACUTE CA
JF - EUR HEART J-ACUTE CA
SN - 2048-8726
IS - 5
ER -