9 results on '"Lurati Buse, Giovanna"'
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2. Die Rolle von kardialen Biomarkern in der perioperativen Risikoevaluation von nichtkardiochirurgischen Patienten – eine Zusammenfassung der ESAIC-Leitlinie 2023
- Author
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M’Pembele, René, Roth, Sebastian, and Lurati Buse, Giovanna
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- 2024
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3. Die Rolle von kardialen Biomarkern in der perioperativen Risikoevaluation von nichtkardiochirurgischen Patienten – eine Zusammenfassung der ESAIC-Leitlinie 2023.
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M'Pembele, René, Roth, Sebastian, and Lurati Buse, Giovanna
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BIOMARKERS ,PERIOPERATIVE care ,TROPONIN ,SURGICAL complications ,MYOCARDIAL injury ,MEDICAL protocols ,PEPTIDE hormones - Abstract
Copyright of Die Anaesthesiologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2024
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4. Perioperative troponin surveillance in major noncardiac surgery: a narrative review
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Chew, Michelle, Saugel, Bernd, and Lurati-Buse, Giovanna
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Anestesi och intensivvård ,Anesthesiology and Pain Medicine ,Anesthesiology and Intensive Care ,biomarker ,cardiac troponins ,MINS ,myocardial injury ,noncardiac surgery ,perioperative outcome - Abstract
Myocardial injury is now an acknowledged complication in patients undergoing noncardiac surgery. Heterogeneity in the definitions of myocardial injury contributes to difficulty in evaluating the value of cardiac troponins (cTns) measurement in perioperative care. Pre-, post-, and peri-operatively increased cTns are encompassed by the umbrella term myocardial injury and are likely to reflect different pathophysiological mechanisms. Increased cTns are independently associated with cardiovascular and non-cardiovascular complications, poor short-term and long-term cardiovascular outcomes, and increased mortality. Preoperative measurement of cTns aids preoperative risk stratification beyond the Revised Cardiac Risk Index. Systematic measurement detects acute perioperative increases and allows early identification of acute myocardial injury. Common definitions and standards for reporting are a prerequisite for designing impactful future trials and perioperative management strategies. Funding Agencies|Swedish Research Council, Sweden [2019-02833]; Linkoping University-Region Ostergotland, ALF, Sweden [687681, 792291]
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- 2023
5. Association between hypotension and myocardial injury in patients with severe trauma.
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Stroda, Alexandra, Thelen, Simon, M'Pembele, René, Khademlou, Nick, Jaekel, Carina, Schiffner, Erik, Bieler, Dan, Bernhard, Michael, Huhn, Ragnar, Lurati Buse, Giovanna, and Roth, Sebastian
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CARDIOPULMONARY resuscitation ,TROPONIN ,CONFIDENCE intervals ,MULTIPLE regression analysis ,MULTIVARIATE analysis ,MAJOR adverse cardiovascular events ,MYOCARDIAL injury ,PATIENTS ,RETROSPECTIVE studies ,DISEASE incidence ,ARTERIAL pressure ,ANTICOAGULANTS ,RISK assessment ,SEVERITY of illness index ,HOSPITAL mortality ,EMERGENCY medical services ,DESCRIPTIVE statistics ,DISEASE duration ,GLASGOW Coma Scale ,HYPOTENSION ,ODDS ratio ,HEMODYNAMICS ,DATA analysis software ,STATISTICAL models ,LOGISTIC regression analysis ,LONGITUDINAL method ,ACUTE kidney failure ,DISEASE risk factors - Abstract
Purpose: During resuscitation of patients with severe trauma, guidelines recommend permissive hypotension prior to surgical bleeding control. However, hypotension may be associated with reduced organ perfusion and multiple organ dysfunction, e.g. myocardial injury. The association between hypotension and myocardial injury in trauma patients is underexplored. We hypothesized that hypotension is associated with myocardial injury in this population. Materials and methods: This retrospective study included patients ≥ 18 years suffering from severe trauma [defined as Injury Severity Score (ISS) ≥ 16] that were treated in the emergency department resuscitation room between 2016 and 2019. Primary endpoint was the incidence of myocardial injury defined as high-sensitive troponin T > 14 ng/l. Main exposure was the duration of arterial hypotension during resuscitation period defined as mean arterial pressure < 65 mmHg. Results: Out of 368 patients screened, 343 were analyzed (73% male, age: 55 ± 21, ISS: 28 ± 12). Myocardial injury was detected in 143 (42%) patients. Overall in-hospital mortality was 26%. Multivariate binary logistic regression with forced entry of nine predefined covariables revealed an odds ratio of 1.29 [95% confidence interval 1.16–1.44]; p = 0.012) for the association between the duration of hypotension and myocardial injury. Conclusion: The duration of hypotension during resuscitation period is independently associated with the incidence of myocardial injury in patients with severe trauma. [ABSTRACT FROM AUTHOR]
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- 2023
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6. Myocardial Injury Is Associated with the Incidence of Major Adverse Cardiac Events in Patients with Severe Trauma.
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Stroda, Alexandra, Jaekel, Carina, M'Pembele, René, Guenther, Alexander, Tenge, Theresa, Thielmann, Carl Maximilian, Thelen, Simon, Schiffner, Erik, Bieler, Dan, Bernhard, Michael, Huhn, Ragnar, Lurati Buse, Giovanna, and Roth, Sebastian
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MAJOR adverse cardiovascular events ,MYOCARDIAL injury ,CARDIAC patients ,RECEIVER operating characteristic curves ,LOGISTIC regression analysis - Abstract
Background: Severe trauma potentially results in end-organ damage such as myocardial injury. Data suggest that myocardial injury is associated with increased mortality in this cohort, but the association with the incidence of in-hospital major adverse cardiac events (MACE) remains undetermined. Methods: Retrospective cohort study including adult patients with severe trauma treated at the University Hospital Duesseldorf between January 2016 and December 2019. The main exposure was myocardial injury at presentation. Endpoints were in-hospital incidence of MACE and incidence of acute kidney injury (AKI) within 72 h. Discrimination of hsTnT for MACE and AKI was examined by the receiver operating characteristic curve (ROC) and the area under the curve (AUC). We conducted multivariate logistic regression analysis. Results: We included 353 patients in our final analysis (72.5% male (256/353), age: 55 ± 21 years). The AUC for hsTnT and MACE was 0.68 [95% confidence interval (CI): 0.59–0.78]. The AUC for hsTnT and AKI was 0.64 [95% (CI): 0.55–0.72]. The adjusted odds ratio (OR) for myocardial injury and MACE was 2.97 [95% (CI): 1.31–6.72], and it was 2.14 [95% (CI): 1.03–4.46] for myocardial injury and AKI. Conclusion: Myocardial injury at presentation in patients with severe trauma is independently associated with the incidence of in-hospital MACE and AKI. [ABSTRACT FROM AUTHOR]
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- 2022
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7. Incidence and prognosis of myocardial injury in patients with severe trauma.
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Stroda, Alexandra, Thelen, Simon, M'Pembele, René, Adelowo, Antony, Jaekel, Carina, Schiffner, Erik, Bieler, Dan, Bernhard, Michael, Huhn, Ragnar, Lurati Buse, Giovanna, and Roth, Sebastian
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INJURY complications ,TROPONIN ,CONFIDENCE intervals ,MULTIVARIATE analysis ,MYOCARDIAL injury ,RETROSPECTIVE studies ,DISEASE incidence ,HOSPITAL mortality ,RISK assessment ,DESCRIPTIVE statistics ,RECEIVER operating characteristic curves ,LOGISTIC regression analysis ,LONGITUDINAL method - Abstract
Purpose: Severe trauma can lead to end organ damages of varying severity, including myocardial injury. In the non-cardiac surgery setting, there is extensive evidence that perioperative myocardial injury is associated with increased morbidity and mortality. The impact of myocardial injury on outcome after severe trauma has not been investigated adequately yet. We hypothesized that myocardial injury is associated with increased in-hospital mortality in patients with severe trauma. Materials/methods: This retrospective cohort study included patients ≥ 18 years with severe trauma [defined as injury severity score (ISS) ≥ 16] that were admitted to the resuscitation room of the Emergency Department of the University Hospital Duesseldorf, Germany, between 2016 and 2019. The main endpoint was in-hospital mortality. Main exposure was myocardial injury at arrival [defined as high-sensitive troponin T (hsTnT) > 14 ng/l]. For statistical analysis, receiver operating characteristic curve (ROC) and multivariate binary logistic regression were performed. Results: Out of 368 patients, 353 were included into statistical analysis (72.5% male, age: 55 ± 21, ISS: 28 ± 12). Overall in-hospital mortality was 26.1%. Myocardial injury at presentation was detected in 149 (42.2%) patients. In-hospital mortality of patients with and without myocardial injury at presentation was 45% versus 12.3%, respectively. The area under the curve (AUC) for hsTnT and mortality was 0.76 [95% confidence interval (CI) 0.71–0.82]. The adjusted odds ratio of myocardial injury for in-hospital mortality was 2.27 ([95%CI 1.16–4.45]; p = 0.017). Conclusion: Myocardial injury after severe trauma is common and independently associated with in-hospital mortality. Thus, hsTnT might serve as a new prognostic marker in this cohort. [ABSTRACT FROM AUTHOR]
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- 2022
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8. Kardiale Biomarker im nichtkardiochirurgischen Setting: Eine Übersicht über kardiale Biomarker zur Risikostratifizierung und Früherkennung postoperativer kardialer Komplikationen.
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Roth, Sebastian, Huhn, Ragnar, Jung, Christian, Polzin, Amin, De Hert, Stefan, and Lurati Buse, Giovanna
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BRAIN natriuretic factor ,NATRIURETIC peptides ,TROPONIN ,BIOMARKERS ,MYOCARDIAL injury - Abstract
Copyright of Medizinische Klinik: Intensivmedizin & Notfallmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2022
- Full Text
- View/download PDF
9. Incidence and outcomes of perioperative myocardial infarction/injury diagnosed by high-sensitivity cardiac troponin I.
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Gualandro, Danielle M., Puelacher, Christian, Lurati Buse, Giovanna, Glarner, Noemi, Cardozo, Francisco A., Vogt, Ronja, Hidvegi, Reka, Strunz, Celia, Bolliger, Daniel, Gueckel, Johanna, Yu, Pai C., Liffert, Marcel, Arslani, Ketina, Prepoudis, Alexandra, Calderaro, Daniela, Hammerer-Lercher, Angelika, Lampart, Andreas, Steiner, Luzius A., Schären, Stefan, and Kindler, Christoph
- Abstract
Background: Perioperative myocardial infarction/injury (PMI) diagnosed by high-sensitivity troponin (hs-cTn) T is frequent and a prognostically important complication of non-cardiac surgery. We aimed to evaluate the incidence and outcome of PMI diagnosed using hs-cTnI, and compare it to PMI diagnosed using hs-cTnT. Methods: We prospectively included 2455 patients at high cardiovascular risk undergoing 3111 non-cardiac surgeries, for whom hs-cTnI and hs-cTnT concentrations were measured before surgery and on postoperative days 1 and 2. PMI was defined as a composite of perioperative myocardial infarction (PMI
Infarct ) and perioperative myocardial injury (PMIInjury ), according to the Fourth Universal Definition of Myocardial Infarction. All-cause mortality was the primary endpoint. Results: Using hs-cTnI, the incidence of overall PMI was 9% (95% confidence interval [CI] 8–10%), including PMIInfarct 2.6% (95% CI 2.0–3.2) and PMIInjury 6.1% (95% CI 5.3–6.9%), which was lower versus using hs-cTnT: overall PMI 15% (95% CI 14–16%), PMIInfarct 3.7% (95% CI 3.0–4.4) and PMIInjury 11.3% (95% CI 10.2–12.4%). All-cause mortality occurred in 52 (2%) patients within 30 days and 217 (9%) within 1 year. Using hs-cTnI, both PMIInfarct and PMIInjury were independent predictors of 30-day all-cause mortality (adjusted hazard ratio [aHR] 2.5 [95% CI 1.1–6.0], and aHR 2.8 [95% CI 1.4–5.5], respectively) and, 1-year all-cause mortality (aHR 2.0 [95% CI 1.2–3.3], and aHR 1.8 [95% CI 1.2–2.7], respectively). Overall, the prognostic impact of PMI diagnosed by hs-cTnI was comparable to the prognostic impact of PMI using hs-cTnT. Conclusions: Using hs-cTnI, PMI is less common versus using hs-cTnT. Using hs-cTnI, both PMIInfarct and PMIInjury remain independent predictors of 30-day and 1-year mortality. [ABSTRACT FROM AUTHOR]- Published
- 2021
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