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Eversion Carotid Endarterectomy: Cardiac Troponin Assessment
Myocardial infarction (MI) is an eversion carotid endarterectomy (eCEA) complication, but most events are unknown, and true incidence and correlation remain controversial. Routine cardiac troponin measurement is a commonly used method for assessing early identification and treatment of MI and stratifying high-risk patients. The aim of the present study is to evaluate the effect of troponin elevation levels following eCEA and to investigate a possible correlation between adverse cardiovascular events and the incidence of postoperative myocardial infarction following emergent vascular surgery. The study included 54 patients who underwent eCEA. High-sensitive troponin I (hsTnI) levels were routinely monitored pre- and postoperatively, with an upper reference range of 34.5 pg/mL for men and 15.6 pg/mL for women. Increases were correlated with demographic and clinical risk factors, as well as clinical or subclinical cardiovascular events. hsTnI was increased in percentage (13%) postoperatively, and non-ST segment elevation MI was diagnosed in eight patients. No patient had clinical symptoms of MI and only two of them presented with simultaneous electrocardiographic changes. Increased levels did not correlate with comorbidities or other surgical risk factors. hsTnI elevation may occur in patients after eCEA and mostly correlates with silent non-ST segment elevation MI that occurred in the early postoperative phase, indicating a possible value as a tool for cardiovascular event diagnosis during the patient's hospitalization.
Keywordsmyocardial injury - myocardial ischemia - cardiac troponin - noncardiac surgery - eversion carotid endarterectomy
T.K. contributed to study design and conception, data analysis and interpretation, critical revisions that are important for the intellectual content, and approval of the final version of the manuscript files submitted to the journal. P.C. contributed to data collection and writing the manuscript. D.T. contributed to data collection and critical revisions that are important for the intellectual content. K.N. contributed to statistical analysis and writing the manuscript.
The author(s) declare(s) that there are patient's consents regarding the publication of this article.
IRB number: 299/02-02-2021.
Article published online:
10 March 2022
© 2022. International College of Angiology. This article is published by Thieme.
Thieme Medical Publishers, Inc.
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