Association between intraoperative hypotension and postoperative myocardial injury in patients with prior coronary stents undergoing high-risk surgery: a retrospective study

Purpose We conducted a single-center retrospective study to evaluate the effects of intraoperative hypotension (IOH) on postoperative myocardial injury during major noncardiac surgery in patients with prior coronary stents with preoperatively normal cardiac troponin I levels. Although IOH is assumed...

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Bibliographic Details
Published in:Journal of anesthesia 2020-04, Vol.34 (2), p.257-267
Main Authors: Lee, Sang Hyun, Kim, Jie Ae, Heo, BurnYoung, Kim, Young Ri, Ahn, Hyun Joo, Yang, Mikyung, Jang, Jaeni, Ahn, Soohyun
Format: Article
Language:English
Subjects:
Anesthesiology
Cardiac patients
Care and treatment
Cohort Studies
Critical Care Medicine
Emergency Medicine
Humans
Hypotension - etiology
Intensive
Intraoperative Complications - diagnosis
Intraoperative Complications - epidemiology
Intraoperative Complications - etiology
Medicine
Medicine & Public Health
Original Article
Pain Medicine
Postoperative Complications - diagnosis
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Retrospective Studies
Stent (Surgery)
Stents
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Summary:Purpose We conducted a single-center retrospective study to evaluate the effects of intraoperative hypotension (IOH) on postoperative myocardial injury during major noncardiac surgery in patients with prior coronary stents with preoperatively normal cardiac troponin I levels. Although IOH is assumed to increase the risk of postoperative myocardial injury in patients with prior coronary stents, the level and duration of hazardous low blood pressure have not been clarified. Methods Of 2517 patients with prior coronary stents undergoing noncardiac surgery between January 2010 and March 2017, we analyzed 195 undergoing major surgery (vascular, abdominal, and thoracic surgery) who had a normal preoperative high-sensitivity cardiac troponin I (hs-cTnI) level and were followed up postoperatively within 3 days. Postoperative myocardial injury was defined as a hs-cTnI level greater than the 99th percentile reference value. Primary IOH exposure was defined as a decrease of ≥ 50%, 40%, or 30% from the preinduction mean blood pressure. Additional definition of IOH was absolute mean blood pressure 
ISSN:0913-8668
1438-8359
DOI:10.1007/s00540-020-02736-4