22 results on '"Hidvegi, Reka"'
Search Results
2. Patient- and procedure-related factors in the pathophysiology of perioperative myocardial infarction/injury
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Badertscher, Patrick, Boeddinghaus, Jasper, Buser, Andreas, Freese, Michael, Hammerer-Lercher, Angelika, Koechlin, Luca, Lopez-Ayala, Pedro, Mehrkens, Arne, Mujagic, Edin, Nestelberger, Thomas, Prepoudis, Alexandra, Mitrovic, Sandra, Rentsch, Katharina, Seeberger, Esther, Vogt, Ronja, Walter, Joan, Wildi, Karin, Wolff, Thomas, Wussler, Desiree, Gueckel, Johanna, Puelacher, Christian, Glarner, Noemi, Gualandro, Danielle M., Strebel, Ivo, Zimmermann, Tobias, Arslani, Ketina, Hidvegi, Reka, Liffert, Marcel, Genini, Alessandro, Marbot, Stella, Schlaepfer, Maria, Steiner, Luzius A., Bolliger, Daniel, Lampart, Andreas, Gürke, Lorenz, Kindler, Christoph, Schären, Stefan, Osswald, Stefan, Clauss, Martin, Rikli, Daniel, Lurati Buse, Giovanna, and Mueller, Christian
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- 2022
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3. Adherence to the European Society of Cardiology/European Society of Anaesthesiology recommendations on preoperative cardiac testing and association with positive results and cardiac events: a cohort study
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Gueckel, Johanna, Strebel, Ivo, Liffert, Marcel, du Fay de Lavallaz, Jeanne, Pouly, Jeanne, Hammerer-Lercher, Angelika, Rentsch, Katharina, Lopez Ayala, Pedro, Osswald, Stefan, Seeberger, Esther, Koechlin, Luca, Buser, Andreas, Rikli, Daniel, Schaeren, Stefan, Lardinois, Didier, Caramelli, Bruno, Lurati Buse, Giovanna A.L., Puelacher, Christian, Gualandro, Danielle Menosi, Kilinc, Derya, Glarner, Noemi, Hidvegi, Reka, Bolliger, Daniel, Arslani, Ketina, Lampart, Andreas, Steiner, Luzius A., Kindler, Christoph, Wolff, Thomas, Mujagic, Edin, Guerke, Lorenz, and Mueller, Christian
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- 2021
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4. Association between self-reported functional capacity and major adverse cardiac events in patients at elevated risk undergoing noncardiac surgery: a prospective diagnostic cohort study
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Gueckel, Johanna, Strebel, Ivo, Liffert, Marcel, Wolff, Thomas, EdinMujagic, Guerke, Lorenz, Hammerer-Lercher, Angelika, Rentsch, Katharina, Boeddinghaus, Jasper, Nestelberger, Thomas, Wildi, Karin, Zimmermann, Tobias, Prepoudis, Alexandra, Lampart, Andreas, Osswald, Stefan, Seeberger, Esther, Koechlin, Luca, Buser, Andreas, Rikli, Daniel, Lurati Buse, Giovanna A.L., Puelacher, Christian, Gualandro, Danielle Menosi, Genini, Alessandro S., Hidvegi, Reka, Bolliger, Daniel, Arslani, Ketina, Steiner, Luzius A., Kindler, Christoph, and Mueller, Christian
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- 2021
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5. Guideline adherence to statin therapy and association with short-term and long-term cardiac complications following noncardiac surgery
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Glarner, Noemi, primary, Puelacher, Christian, additional, Gualandro, Danielle Menosi, additional, Lurati Buse, Giovanna, additional, Hidvegi, Reka, additional, Bolliger, Daniel, additional, Lampart, Andreas, additional, Burri, Katrin, additional, Pargger, Mirjam, additional, Gerhard, Hatice, additional, Weder, Samantha, additional, Maiorano, Silvia, additional, Meister, Rebecca, additional, Tschan, Carla, additional, Osswald, Stefan, additional, Steiner, Luzius A., additional, Guerke, Lorenz, additional, Kappos, Elisabeth A., additional, Clauss, Martin, additional, Filipovic, Miodrag, additional, Arenja, Nisha, additional, and Mueller, Christian, additional
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- 2023
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6. Prediction of perioperative myocardial infarction/injury in high-risk patients after noncardiac surgery.
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Meister, Rebecca, Puelacher, Christian, Glarner, Noemi, Gualandro, Danielle Menosi, Andersson, Henrik A, Pargger, Mirjam, Huré, Gabrielle, Virant, Georgiana, Bolliger, Daniel, Lampart, Andreas, Steiner, Luzius, Hidvegi, Reka, Lurati Buse, Giovanna, Kindler, Christoph, Gürke, Lorenz, Mujagic, Edin, Schaeren, Stefan, Clauss, Martin, Lardinois, Didier, and Hammerer-Lercher, Angelika
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- 2023
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7. Acute heart failure after non-cardiac surgery: incidence, phenotypes, determinants and outcomes
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Gualandro, Danielle M. M., Puelacher, Christian, Chew, Michelle, Andersson, Henrik, Buse, Giovanna Lurati, Glarner, Noemi, Mueller, Daria, Cardozo, Francisco A. M., Burri-Winkler, Katrin, Mork, Constantin, Wussler, Desiree, Shrestha, Samyut, Heidelberger, Isabelle, Fält, Mikael, Hidvegi, Reka, Bolliger, Daniel, Lampart, Andreas, Steiner, Luzius A. A., Scharen, Stefan, Kindler, Christoph, Gurke, Lorenz, Rikli, Daniel, Lardinois, Didier, Osswald, Stefan, Buser, Andreas, Caramelli, Bruno, Mueller, Christian, Gualandro, Danielle M. M., Puelacher, Christian, Chew, Michelle, Andersson, Henrik, Buse, Giovanna Lurati, Glarner, Noemi, Mueller, Daria, Cardozo, Francisco A. M., Burri-Winkler, Katrin, Mork, Constantin, Wussler, Desiree, Shrestha, Samyut, Heidelberger, Isabelle, Fält, Mikael, Hidvegi, Reka, Bolliger, Daniel, Lampart, Andreas, Steiner, Luzius A. A., Scharen, Stefan, Kindler, Christoph, Gurke, Lorenz, Rikli, Daniel, Lardinois, Didier, Osswald, Stefan, Buser, Andreas, Caramelli, Bruno, and Mueller, Christian
- Abstract
Aims Primary acute heart failure (AHF) is a common cause of hospitalization. AHF may also develop postoperatively (pAHF). The aim of this study was to assess the incidence, phenotypes, determinants and outcomes of pAHF following non-cardiac surgery.Methods and results A total of 9164 consecutive high-risk patients undergoing 11 262 non-cardiac inpatient surgeries were prospectively included. The incidence, phenotypes, determinants and outcome of pAHF, centrally adjudicated by independent cardiologists, were determined. The incidence of pAHF was 2.5% (95% confidence interval [CI] 2.2-2.8%); 51% of pAHF occurred in patients without known heart failure (de novo pAHF), and 49% in patients with chronic heart failure. Among patients with chronic heart failure, 10% developed pAHF, and among patients without a history of heart failure, 1.5% developed pAHF. Chronic heart failure, diabetes, urgent/emergent surgery, atrial fibrillation, cardiac troponin elevations above the 99th percentile, chronic obstructive pulmonary disease, anaemia, peripheral artery disease, coronary artery disease, and age, were independent predictors of pAHF in the logistic regression model. Patients with pAHF had significantly higher all-cause mortality (44% vs. 11%, p < 0.001) and AHF readmission (15% vs. 2%, p < 0.001) within 1 year than patients without pAHF. After Cox regression analysis, pAHF was an independent predictor of all-cause mortality (adjusted hazard ratio [aHR] 1.7 [95% CI 1.3-2.2]; p < 0.001) and AHF readmission (aHR 2.3 [95% CI 1.5-3.7]; p < 0.001). Findings were confirmed in an external validation cohort using a prospective multicentre cohort of 1250 patients (incidence of pAHF 2.4% [95% CI 1.6-3.3%]).Conclusions Postoperative AHF frequently developed following non-cardiac surgery, being de novo in half of cases, and associated with a very high mortality., Funding Agencies|Swiss National Science Foundation; Swiss Heart Foundation; University Hospital Basel; University of Basel; AstraZeneca; Abbott; Roche; Clinical Research Program of the University of Basel; Spezialprogramm Nachwuchsforderung Klinische Forschung; Forderung Exzellenter Junger Forschender; Forschung fond Kantonsspital Aarau; Swiss Academy of Medical Sciences; Bangerter Foundation; Fundacao de Amparo a Pesquisa do Estado de Sao Paulo; Brazil [FAPESP] [2015/23731-6]; Swedish Research Council [2019-02833]; South Eastern Sweden Research Council [746981, 712291]; LinkopingUniversity-Region_Osterg_otland ALF [687681, 792291]
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- 2023
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8. Acute heart failure after non‐cardiac surgery: incidence, phenotypes, determinants and outcomes.
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Gualandro, Danielle M., Puelacher, Christian, Chew, Michelle S., Andersson, Henrik, Lurati Buse, Giovanna, Glarner, Noemi, Mueller, Daria, Cardozo, Francisco A.M., Burri‐Winkler, Katrin, Mork, Constantin, Wussler, Desiree, Shrestha, Samyut, Heidelberger, Isabelle, Fält, Mikael, Hidvegi, Reka, Bolliger, Daniel, Lampart, Andreas, Steiner, Luzius A., Schären, Stefan, and Kindler, Christoph
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HEART failure ,CHRONIC obstructive pulmonary disease ,HEART failure patients ,PERIPHERAL vascular diseases ,ANKLE brachial index ,CORONARY artery disease - Abstract
Aims: Primary acute heart failure (AHF) is a common cause of hospitalization. AHF may also develop postoperatively (pAHF). The aim of this study was to assess the incidence, phenotypes, determinants and outcomes of pAHF following non‐cardiac surgery. Methods and results: A total of 9164 consecutive high‐risk patients undergoing 11 262 non‐cardiac inpatient surgeries were prospectively included. The incidence, phenotypes, determinants and outcome of pAHF, centrally adjudicated by independent cardiologists, were determined. The incidence of pAHF was 2.5% (95% confidence interval [CI] 2.2–2.8%); 51% of pAHF occurred in patients without known heart failure (de novo pAHF), and 49% in patients with chronic heart failure. Among patients with chronic heart failure, 10% developed pAHF, and among patients without a history of heart failure, 1.5% developed pAHF. Chronic heart failure, diabetes, urgent/emergent surgery, atrial fibrillation, cardiac troponin elevations above the 99th percentile, chronic obstructive pulmonary disease, anaemia, peripheral artery disease, coronary artery disease, and age, were independent predictors of pAHF in the logistic regression model. Patients with pAHF had significantly higher all‐cause mortality (44% vs. 11%, p < 0.001) and AHF readmission (15% vs. 2%, p < 0.001) within 1 year than patients without pAHF. After Cox regression analysis, pAHF was an independent predictor of all‐cause mortality (adjusted hazard ratio [aHR] 1.7 [95% CI 1.3–2.2]; p < 0.001) and AHF readmission (aHR 2.3 [95% CI 1.5–3.7]; p < 0.001). Findings were confirmed in an external validation cohort using a prospective multicentre cohort of 1250 patients (incidence of pAHF 2.4% [95% CI 1.6–3.3%]). Conclusions: Postoperative AHF frequently developed following non‐cardiac surgery, being de novo in half of cases, and associated with a very high mortality. [ABSTRACT FROM AUTHOR]
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- 2023
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9. Patient- and procedure-related factors in the pathophysiology of perioperative myocardial infarction/injury
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Gueckel, Johanna, primary, Puelacher, Christian, additional, Glarner, Noemi, additional, Gualandro, Danielle M., additional, Strebel, Ivo, additional, Zimmermann, Tobias, additional, Arslani, Ketina, additional, Hidvegi, Reka, additional, Liffert, Marcel, additional, Genini, Alessandro, additional, Marbot, Stella, additional, Schlaepfer, Maria, additional, Steiner, Luzius A., additional, Bolliger, Daniel, additional, Lampart, Andreas, additional, Gürke, Lorenz, additional, Kindler, Christoph, additional, Schären, Stefan, additional, Osswald, Stefan, additional, Clauss, Martin, additional, Rikli, Daniel, additional, Lurati Buse, Giovanna, additional, Mueller, Christian, additional, Badertscher, Patrick, additional, Boeddinghaus, Jasper, additional, Buser, Andreas, additional, Freese, Michael, additional, Hammerer-Lercher, Angelika, additional, Koechlin, Luca, additional, Lopez-Ayala, Pedro, additional, Mehrkens, Arne, additional, Mujagic, Edin, additional, Nestelberger, Thomas, additional, Prepoudis, Alexandra, additional, Mitrovic, Sandra, additional, Rentsch, Katharina, additional, Seeberger, Esther, additional, Vogt, Ronja, additional, Walter, Joan, additional, Wildi, Karin, additional, Wolff, Thomas, additional, and Wussler, Desiree, additional
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- 2022
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10. Cardiovascular Imaging Following Perioperative Myocardial Infarction/Injury
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Arslani, Ketina, primary, Gualandro, Danielle M, additional, Puelacher, Christian, additional, Buse, Giovanna Lurati, additional, Lampart, Andreas, additional, Bolliger, Daniel, additional, Schulthess, David, additional, Glarner, Noemi, additional, Hidvegi, Reka, additional, Kindler, Christoph, additional, Blum, Steffen, additional, Cardozo, Francisco A, additional, Caramelli, Bruno, additional, Gürke, Lorenz, additional, Wolff, Thomas, additional, Mujagic, Edin, additional, Schaeren, Stefan, additional, Rikli, Daniel, additional, Campos, Carlos A, additional, Fahrni, Gregor, additional, Kaufmann, Beat A, additional, Haaf, Philip, additional, Zellweger, Michael J, additional, Kaiser, Christoph, additional, Osswald, Stefan, additional, Steiner, Luzius A, additional, and Mueller, Christian, additional
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- 2021
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11. Adherence to the European Society of Cardiology/European Society of Anaesthesiology recommendations on preoperative cardiac testing and association with positive results and cardiac events: a cohort study
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Lurati Buse, Giovanna A.L., primary, Puelacher, Christian, additional, Gualandro, Danielle Menosi, additional, Kilinc, Derya, additional, Glarner, Noemi, additional, Hidvegi, Reka, additional, Bolliger, Daniel, additional, Arslani, Ketina, additional, Lampart, Andreas, additional, Steiner, Luzius A., additional, Kindler, Christoph, additional, Wolff, Thomas, additional, Mujagic, Edin, additional, Guerke, Lorenz, additional, Mueller, Christian, additional, Gueckel, Johanna, additional, Strebel, Ivo, additional, Liffert, Marcel, additional, du Fay de Lavallaz, Jeanne, additional, Pouly, Jeanne, additional, Hammerer-Lercher, Angelika, additional, Rentsch, Katharina, additional, Lopez Ayala, Pedro, additional, Osswald, Stefan, additional, Seeberger, Esther, additional, Koechlin, Luca, additional, Buser, Andreas, additional, Rikli, Daniel, additional, Schaeren, Stefan, additional, Lardinois, Didier, additional, and Caramelli, Bruno, additional
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- 2021
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12. Association between self-reported functional capacity and major adverse cardiac events in patients at elevated risk undergoing noncardiac surgery: a prospective diagnostic cohort study
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Lurati Buse, Giovanna A. L., Puelacher, Christian, Gualandro, Danielle Menosi, Genini, Alessandro S., Hidvegi, Reka, Bolliger, Daniel, Arslani, Ketina, Steiner, Luzius A., Kindler, Christoph, Mueller, Christian, and Basel-PMI Investigators
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- 2021
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13. Adherence to the European Society of Cardiology/European Society of Anaesthesiology recommendations on preoperative cardiac testing and association with positive results and cardiac events: a cohort study
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Lurati Buse, Giovanna A. L., Puelacher, Christian, Gualandro, Danielle Menosi, Kilinc, Derya, Glarner, Noemi, Hidvegi, Reka, Bolliger, Daniel, Arslani, Ketina, Lampart, Andreas, Steiner, Luzius A., Kindler, Christoph, Wolff, Thomas, Mujagic, Edin, Guerke, Lorenz, Mueller, Christian, Incidence, and Outcome of Perioperative Myocardial Injury After Non-cardiac Sur
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- 2021
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14. Biomarker-Based Preoperative Risk Stratification for Patients Undergoing Non-Cardiac Surgery
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Yurttas, Timur, primary, Hidvegi, Reka, additional, and Filipovic, Miodrag, additional
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- 2020
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15. Daytime variation of perioperative myocardial injury in non-cardiac surgery and effect on outcome
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du Fay de Lavallaz, Jeanne, Puelacher, Christian, Lurati Buse, Giovanna, Bolliger, Daniel, Germanier, Dominic, Hidvegi, Reka, Walter, Joan Elias, Twerenbold, Raphael, Strebel, Ivo, Badertscher, Patrick, Sazgary, Lorraine, Lampart, Andreas, Espinola, Jaqueline, Kindler, Christoph, Hammerer-Lercher, Angelika, Thambipillai, Saranya, Guerke, Lorenz, Rentsch, Katharina, Buser, Andreas, Gualandro, Danielle, Jakob, Marcel, Mueller, Christian, and Basel-PMI Investigators
- Subjects
Male ,medicine.medical_specialty ,Myocardial Infarction ,030204 cardiovascular system & hematology ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Troponin T ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Myocardial infarction ,Propensity Score ,Aged ,Morning ,business.industry ,Incidence ,Incidence (epidemiology) ,Perioperative ,Prognosis ,medicine.disease ,Circadian Rhythm ,Cardiac surgery ,C-Reactive Protein ,Surgical Procedures, Operative ,Anesthesia ,Preoperative Period ,Cohort ,Propensity score matching ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Switzerland ,Follow-Up Studies - Abstract
ObjectiveRecently, daytime variation in perioperative myocardial injury (PMI) has been observed in patients undergoing cardiac surgery. We aim at investigating whether daytime variation also occurs in patients undergoing non-cardiac surgery.MethodsIn a prospective diagnostic study, we evaluated the presence of daytime variation in PMI in patients at increased cardiovascular risk undergoing non-cardiac surgery, as well as its possible impact on the incidence of acute myocardial infarction (AMI), and death during 1-year follow-up in a propensity score–matched cohort. PMI was defined as an absolute increase in high-sensitivity cardiac troponin T (hs-cTnT) concentration of ≥14 ng/L from preoperative to postoperative measurements.ResultsOf 1641 patients, propensity score matching defined 630 with similar baseline characteristics, half undergoing non-cardiac surgery in the morning (starting from 8:00 to 11:00) and half in the afternoon (starting from 14:00 to 17:00). There was no difference in PMI incidence between both groups (morning: 50, 15.8% (95% CI 12.3 to 20.3); afternoon: 52, 16.4% (95% CI 12.7 to 20.9), p=0.94), nor if analysing hs-cTnT release as a quantitative variable (median morning group: 3 ng/L (95% CI 1 to 7 ng/L); median afternoon group: 2 ng/L (95% CI 0 to 7 ng/L; p=0.16). During 1-year follow-up, the incidence of AMI was 1.2% (95% CI 0.4% to 3.2%) among morning surgeries versus 4.1% (95% CI 2.3% to 6.9%) among the afternoon surgeries (corrected HR for afternoon surgery 3.44, bootstrapped 95% CI 1.33 to 10.49, p log-rank=0.03), whereas no difference in mortality emerged (p=0.70).ConclusionsAlthough there is no daytime variation in PMI in patients undergoing non-cardiac surgery, the incidence of AMI during follow-up is increased in afternoon surgeries and requires further study.Clinical trial registrationNCT02573532;Results.
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- 2019
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16. 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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17. Incidence of major adverse cardiac events following non-cardiac surgery.
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Sazgary, Lorraine, Puelacher, Christian, Buse, Giovanna Lurati, 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, and Hollenstein, Christina
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- 2021
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18. Daytime variation of perioperative myocardial injury in non-cardiac surgery and effect on outcome
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du Fay de Lavallaz, Jeanne, primary, Puelacher, Christian, additional, Lurati Buse, Giovanna, additional, Bolliger, Daniel, additional, Germanier, Dominic, additional, Hidvegi, Reka, additional, Walter, Joan Elias, additional, Twerenbold, Raphael, additional, Strebel, Ivo, additional, Badertscher, Patrick, additional, Sazgary, Lorraine, additional, Lampart, Andreas, additional, Espinola, Jaqueline, additional, Kindler, Christoph, additional, Hammerer-Lercher, Angelika, additional, Thambipillai, Saranya, additional, Guerke, Lorenz, additional, Rentsch, Katharina, additional, Buser, Andreas, additional, Gualandro, Danielle, additional, Jakob, Marcel, additional, and Mueller, Christian, additional
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- 2018
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19. Obesity paradox and perioperative myocardial infarction/injury in non-cardiac surgery.
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Hidvegi, Reka, Puelacher, Christian, Gualandro, Danielle M., Lampart, Andreas, Lurati Buse, Giovanna, Hammerer-Lerchner, Angelika, Walter, Joan, Liffert, Marcel, Bolliger, Daniel, Steiner, Luzius, Kindler, Christoph, Espinola, Jaqueline, Strebel, Ivo, Gueckel, Johanna, Marbot, Stella, Arslani, Ketina, Boeddinghaus, Jasper, Nestelberger, Thomas, Zimmermann, Tobias, and Freese, Michael
- Abstract
Background: The impact of obesity on the incidence of perioperative myocardial infarction/injury (PMI) and mortality following non-cardiac surgery is not well understood. Methods: We performed a prospective diagnostic study enrolling consecutive patients undergoing non-cardiac surgery, who were considered at increased cardiovascular risk. All patients were screened for PMI, defined as an absolute increase from preoperative to postoperative sensitive/high-sensitivity cardiac troponin T (hs-cTnT) concentrations. The body mass index (BMI) was classified according to the WHO classification (underweight< 18 kg/m
2 , normal weight 18–24.9 kg/m2 , overweight 25–29.9 kg/m2 , obesity class I 30–34.9 kg/m2 , obesity class II 35–39.9 kg/m2 , obesity class III > 40 kg/m2 ). The incidence of PMI and all-cause mortality at 365 days, both stratified according to BMI. Results: We enrolled 4277 patients who had undergone 5413 surgeries. The median BMI was 26 kg/m2 (interquartile range 23–30 kg/m2 ). Incidence of PMI showed a non-linear relationship with BMI and ranged from 12% (95% CI 9–14%) in obesity class I to 19% (95% CI 17–42%) in the underweight group. This was confirmed in multivariable analysis with obesity class I. showing the lowest risk (adjusted OR 0.64; 95% CI 0.49–0.83) for developing PMI. Mortality at 365 days was lower in all obesity groups compared to patients with normal body weight (e.g., unadjusted OR 0.54 (95% CI 0.39–0.73) and adjusted OR 0.52 (95% CI 0.38–0.71) in obesity class I). Conclusion: Obesity class I was associated with a lower incidence of PMI, and obesity in general was associated with a lower all-cause mortality at 365 days. [ABSTRACT FROM AUTHOR]- Published
- 2020
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20. Daytime variation of perioperative myocardial injury in non-cardiac surgery and effect on outcome.
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de Lavallaz, Jeanne du Fay, Puelacher, Christian, Buse, Giovanna Lurati, Bolliger, Daniel, Germanier, Dominic, Hidvegi, Reka, Walter, Joan Elias, Twerenbold, Raphael, Strebel, Ivo, Badertscher, Patrick, Sazgary, Lorraine, Lampart, Andreas, Espinola, Jaqueline, Kindler, Christoph, Hammerer-Lercher, Angelika, Thambipillai, Saranya, Guerke, Lorenz, Rentsch, Katharina, Buser, Andreas, and Gualandro, Danielle
- Subjects
ASPIRIN ,TYPE 1 diabetes ,SURGERY - Abstract
Objective: Recently, daytime variation in perioperative myocardial injury (PMI) has been observed in patients undergoing cardiac surgery. We aim at investigating whether daytime variation also occurs in patients undergoing non-cardiac surgery.Methods: In a prospective diagnostic study, we evaluated the presence of daytime variation in PMI in patients at increased cardiovascular risk undergoing non-cardiac surgery, as well as its possible impact on the incidence of acute myocardial infarction (AMI), and death during 1-year follow-up in a propensity score-matched cohort. PMI was defined as an absolute increase in high-sensitivity cardiac troponin T (hs-cTnT) concentration of ≥14 ng/L from preoperative to postoperative measurements.Results: Of 1641 patients, propensity score matching defined 630 with similar baseline characteristics, half undergoing non-cardiac surgery in the morning (starting from 8:00 to 11:00) and half in the afternoon (starting from 14:00 to 17:00). There was no difference in PMI incidence between both groups (morning: 50, 15.8% (95% CI 12.3 to 20.3); afternoon: 52, 16.4% (95% CI 12.7 to 20.9), p=0.94), nor if analysing hs-cTnT release as a quantitative variable (median morning group: 3 ng/L (95% CI 1 to 7 ng/L); median afternoon group: 2 ng/L (95% CI 0 to 7 ng/L; p=0.16). During 1-year follow-up, the incidence of AMI was 1.2% (95% CI 0.4% to 3.2%) among morning surgeries versus 4.1% (95% CI 2.3% to 6.9%) among the afternoon surgeries (corrected HR for afternoon surgery 3.44, bootstrapped 95% CI 1.33 to 10.49, p log-rank=0.03), whereas no difference in mortality emerged (p=0.70).Conclusions: Although there is no daytime variation in PMI in patients undergoing non-cardiac surgery, the incidence of AMI during follow-up is increased in afternoon surgeries and requires further study.Clinical Trial Registration: NCT02573532;Results. [ABSTRACT FROM AUTHOR]- Published
- 2019
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- View/download PDF
21. Association between self-reported functional capacity and major adverse cardiac events in patients at elevated risk undergoing noncardiac surgery: a prospective diagnostic cohort study.
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Lurati Buse, Giovanna A.L., Puelacher, Christian, Menosi Gualandro, Danielle, Genini, Alessandro S., Hidvegi, Reka, Bolliger, Daniel, Arslani, Ketina, Steiner, Luzius A., Kindler, Christoph, Mueller, Christian, BASEL-PMI Investigators, and Gualandro, Danielle Menosi
- Subjects
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CARDIAC patients , *METABOLIC equivalent , *COHORT analysis , *RISK assessment , *STANDARD deviations , *RESEARCH , *EXERCISE tolerance , *SELF-evaluation , *RESEARCH methodology , *ACTIVITIES of daily living , *SURGICAL complications , *EVALUATION research , *MEDICAL cooperation , *COMPARATIVE studies , *HEART failure , *LONGITUDINAL method - Abstract
Background: Perioperative cardiovascular guidelines endorse functional capacity estimation, based on 'cut-off' daily activities for risk assessment and climbing two flights of stairs to approximate 4 metabolic equivalents. We assessed the association between self-reported functional capacity and postoperative cardiac events.Methods: Consecutive patients at elevated cardiovascular risk undergoing in-patient noncardiac surgery were included in this predefined secondary analysis. Self-reported ability to walk up two flights of stairs was extracted from electronic charts. The primary endpoint was a composite of cardiac death and cardiac events at 30 days. Secondary endpoints included the same composite at 1 yr, all-cause mortality, and myocardial injury.Results: Among the 4560 patients, mean (standard deviation) age 73 (SD 8 yr) yr, classified as American Society of Anesthesiologists physical status ≥3 in 61% (n=2786/4560), the 30-day and 1-yr incidences of major adverse cardiac events were 5.7% (258/4560) and 11.2% (509/4560), respectively. Functional capacity less than two flights of stairs was associated with the 30-day composite endpoint (adjusted hazard ratio 1.63, 95% confidence interval [CI] 1.23-2.15) and all other endpoints. The addition of functional capacity information to the revised cardiac risk index (RCRI) significantly improved risk classification (functional capacity plus RCRI vs RCRI: net reclassification improvement [NRI]Events 6.2 [95% CI 3.6-9.9], NRINonevents19.2 [95% CI 18.1-20.0]).Conclusions: In patients at high cardiovascular risk undergoing noncardiac surgery, self-reported functional capacity less than two flights of stairs was independently associated with major adverse cardiac events and all-cause mortality at 30 days and 1 yr. The addition of self-reported functional capacity to surgical and clinical risk improved risk classification.Clinical Trial Registration: INCT 02573532. [ABSTRACT FROM AUTHOR]- Published
- 2021
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22. Daytime variation of perioperative myocardial injury in non-cardiac surgery and effect on outcome.
- Author
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du Fay de Lavallaz J, Puelacher C, Lurati Buse G, Bolliger D, Germanier D, Hidvegi R, Walter JE, Twerenbold R, Strebel I, Badertscher P, Sazgary L, Lampart A, Espinola J, Kindler C, Hammerer-Lercher A, Thambipillai S, Guerke L, Rentsch K, Buser A, Gualandro D, Jakob M, and Mueller C
- Subjects
- Aged, Biomarkers blood, Female, Follow-Up Studies, Humans, Incidence, Male, Myocardial Infarction blood, Myocardial Infarction epidemiology, Preoperative Period, Prognosis, Prospective Studies, Switzerland epidemiology, C-Reactive Protein metabolism, Circadian Rhythm physiology, Myocardial Infarction diagnosis, Propensity Score, Surgical Procedures, Operative, Troponin T blood
- Abstract
Objective: Recently, daytime variation in perioperative myocardial injury (PMI) has been observed in patients undergoing cardiac surgery. We aim at investigating whether daytime variation also occurs in patients undergoing non-cardiac surgery., Methods: In a prospective diagnostic study, we evaluated the presence of daytime variation in PMI in patients at increased cardiovascular risk undergoing non-cardiac surgery, as well as its possible impact on the incidence of acute myocardial infarction (AMI), and death during 1-year follow-up in a propensity score-matched cohort. PMI was defined as an absolute increase in high-sensitivity cardiac troponin T (hs-cTnT) concentration of ≥14 ng/L from preoperative to postoperative measurements., Results: Of 1641 patients, propensity score matching defined 630 with similar baseline characteristics, half undergoing non-cardiac surgery in the morning (starting from 8:00 to 11:00) and half in the afternoon (starting from 14:00 to 17:00). There was no difference in PMI incidence between both groups (morning: 50, 15.8% (95% CI 12.3 to 20.3); afternoon: 52, 16.4% (95% CI 12.7 to 20.9), p=0.94), nor if analysing hs-cTnT release as a quantitative variable (median morning group: 3 ng/L (95% CI 1 to 7 ng/L); median afternoon group: 2 ng/L (95% CI 0 to 7 ng/L; p=0.16). During 1-year follow-up, the incidence of AMI was 1.2% (95% CI 0.4% to 3.2%) among morning surgeries versus 4.1% (95% CI 2.3% to 6.9%) among the afternoon surgeries (corrected HR for afternoon surgery 3.44, bootstrapped 95% CI 1.33 to 10.49, p log-rank=0.03), whereas no difference in mortality emerged (p=0.70)., Conclusions: Although there is no daytime variation in PMI in patients undergoing non-cardiac surgery, the incidence of AMI during follow-up is increased in afternoon surgeries and requires further study., Clinical Trial Registration: NCT02573532;Results., Competing Interests: Competing interests: CP reports grants from PhD Educational Platform for Health Sciences and the University Hospital Basel during the conduct of the study. GLB reports grants from University of Basel during the conduct of the study. RT reports research support from the Swiss National Science Foundation (grant no. P300PB 167803), the Swiss Heart Foundation, the Cardiovascular Research Foundation Basel, the University of Basel and the University Hospital Basel; and speaker honoraria/consulting honoraria from Roche, Abbott, Siemens, Singulex and ThermoScientific BRAHMS. CM reports grants from the Swiss Heart Foundation and grants and non-financial support from several diagnostic companies during the conduct of the study, as well as grants, personal fees and non-financial support from several diagnostic companies outside the submitted work., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2019
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