European Association of Cardio-Thoracic Surgery (EACTS) expert consensus statement on perioperative myocardial infarction after cardiac surgery.

Cardiac surgery may lead to myocardial damage and release of cardiac biomarkers through various mechanisms such as cardiac manipulation, systemic inflammation, myocardial hypoxia, cardioplegic arrest and ischaemia caused by coronary or graft occlusion. Defining perioperative myocardial infarction (PMI) after cardiac surgery presents challenges, and the association between the current PMI definitions and postoperative outcomes remains uncertain. To address these challenges, the European Association of Cardio-Thoracic Surgery (EACTS) facilitated collaboration among a multidisciplinary group to evaluate the existing evidence on the mechanisms, diagnosis and prognostic implications of PMI after cardiac surgery. The review found that the postoperative troponin value thresholds associated with an increased risk of mortality are markedly higher than those proposed by all the current definitions of PMI. Additionally, it was found that large postoperative increases in cardiac biomarkers are prognostically relevant even in absence of additional supportive signs of ischaemia. A new algorithm for PMI detection after cardiac surgery was also proposed, and a consensus was reached within the group that establishing a prognostically relevant definition of PMI is critically needed in the cardiovascular field and that PMI should be included in the primary composite outcome of coronary intervention trials.

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Humans
Thoracic Surgery
Creatine Kinase
Biomarkers
Myocardial Infarction
diagnosis
etiology
Cardiac Surgical Procedures
adverse effects

Flather, Marcus (author)
Capodanno, Davide (author)
Milojevic, Milan (author)
Bhatt, Deepak L (author)
Biondi Zoccai, Giuseppe (author)
Boden, William E (author)
Devereaux, P J (author)
Doenst, Torsten (author)
Farkouh, Michael (author)
Freemantle, Nicholas (author)
Fremes, Stephen (author)
Puskas, John (author)
Landoni, Giovanni (author)
Lawton, Jennifer (author)
Myers, Patrick O (author)
Redfors, BjörnGothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xredbj (author)
Sandner, Sigrid (author)
Göteborgs universitetInstitutionen för medicin, avdelningen för molekylär och klinisk medicin (creator_code:org_t)

In:European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery65:21873-734X

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

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