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Impact of the American College of Cardiology/American Heart Association guidelines for interpretability of continuous electrocardiography on the association of silent ischemia with troponin release after major noncardiac surgery.
- Source :
- Journal of Electrocardiology; Sep2009, Vol. 42 Issue 5, p455-461.e1, 0p
- Publication Year :
- 2009
-
Abstract
- Abstract: Introduction: Preexisting electrocardiographic abnormalities may limit accuracy of continuous electrocardiography (cECG) for ischemia determination. The American College of Cardiology/American Heart Association published criteria for the exclusion of unsuitable cECG curves from ST-segment interpretation. These criteria consider medication and 12-lead ECG findings (medication- and 12-lead ECG-based criteria) and cECG lead characteristics (cECG-based criteria). Methods: We recorded cECG in 300 patients undergoing major noncardiac surgery. We determined postoperative troponin and 12-month outcome. We compared the associations of cECG-detected ischemia with troponin and 12-month outcome with and without adherence to the criteria. Results: Adherence to the medication- and 12-lead ECG-based criteria enhanced the association between troponin and perioperative ischemia in CM5 (odds ratio, 3.74; 95% confidence interval, 1.88-7.44) and 7.03 (2.67-18.49), respectively; P = .049). Similarly, the association between ischemia in CM5 and 12-month outcome tended to increase (P = .081). Conclusions: Applying the guideline criteria for the interpretation of cECG enhanced cECG diagnostic value in surgical patients. [Copyright &y& Elsevier]
Details
- Language :
- English
- ISSN :
- 00220736
- Volume :
- 42
- Issue :
- 5
- Database :
- Supplemental Index
- Journal :
- Journal of Electrocardiology
- Publication Type :
- Academic Journal
- Accession number :
- 43876056
- Full Text :
- https://doi.org/10.1016/j.jelectrocard.2009.05.008