Cardiovascular imaging following perioperative myocardial infarction/injury

Author(s):Show less -

Arslani, Ketina ; Gualandro, Danielle M. ; Puelacher, Christian ; Buse, Giovanna Lurati ; Lampart, Andreas ; Bolliger, Daniel ; Schulthess, David ; Glarner, Noemi ; Hidvegi, Reka ; Kindler, Christoph ; Blum, Steffen ; Cardozo, Francisco A. M. ; Caramelli, Bruno ; Guerke, Lorenz ; Wolff, Thomas ; Mujagic, Edin ; Schaeren, Stefan ; Rikli, Daniel ; Campos, Carlos A. ; Fahrni, Gregor ; Kaufmann, Beat A. ; Haaf, Philip ; Zellweger, Michael J. ; Kaiser, Christoph ; Osswald, Stefan ; Steiner, Luzius A. ; Mueller, Christian ; BASEL-PM Investigators

• Document type: Journal article
• Source: SCIENTIFIC REPORTS; v. 12, n. 1, p. 11-pg., 2022-03-15.

Abstract

Patients developing perioperative myocardial infarction/injury (PMI) have a high mortality. PMI work-up and therapy remain poorly defined. This prospective multicenter study included highrisk patients undergoing major non-cardiac surgery within a systematic PMI screening and clinical response program. The frequency of cardiovascular imaging during PMI work-up and its yield for possible type 1 myocardial infarction (T1MI) was assessed. Automated PMI detection triggered evaluation by the treating physician/cardiologist, who determined selection/timing of cardiovascular imaging. T1M1 was considered with the presence of a new wall motion abnormality within 30 days in transthoracic echocardiography (TTE), a new scar or ischemia within 90 days in myocardial perfusion imaging (MPI), and Ambrose-Type II or complex lesions within 7 days of PMI in coronary angiography (CA). In patients with PMI, 21% (268/1269) underwent at least one cardiac imaging modality. TTE was used in 13% (163/1269), MPI in 3% (37/1269), and CA in 5% (68/1269). Cardiology consultation was associated with higher use of cardiovascular imaging (27% versus 13%). Signs indicative of T1MI were found in 8% of TTE, 46% of MPI, and 63% of CA. Most patients with PMI did not undergo any cardiovascular imaging within their PMI work-up. If performed, MPI and CA showed high yield for signs indicative of T1MI. (AU)

• FAPESP's process: 15/23731-6 - Evaluation of high- sensitive troponin elevation and cardiovascular events after vascular surgery
• Grantee: Danielle Menosi Gualandro
• Support Opportunities: Regular Research Grants