Incidence and Predictors of Myocardial and Kidney Injury following Endovascular Aortic Repair: A Retrospective Cohort Study
Published: Can J Anaesth. 2019 Nov;66(11):1338-1346
Authors: Emmanuelle Duceppe, Dorota Studzińska, P. J. Devereaux, Kamil Polok, Anna Gajdosz, Krzysztof Lewandowski, Maciej Zaniewski, Marcin Zaczek, Bogusław Rudel and Wojciech Szczeklik
A retrospective study at two tertiary centres to investigate the incidence and predictors of myocardial injury and acute kidney injury (AKI) after endovascular aneurysm repair (EVAR)
- Two tertiary centres in Canada and Poland performed this retrospective study on 267 patients underwent EVAR.
- Myocardial injury was defined as a troponin elevation above the 99th percentile upper reference limit for troponin I, and peak troponin T thresholds similar to the VISION studies.
- AKI was defined as a stage 1 Acute Kidney Injury Network criteria.
- Myocardial injury occurred in 78/267 (29%) of patients (95% confidence interval [CI], 24.1 to 34.9), while 25/267 (9.4%) of patients experienced AKI.
- The risk factors for myocardial injury were increasing age, Revised Cardiac Risk Index (RCRI) score ≥ 3, ASA physical status score of 4, increasing duration of surgery and the perioperative haemoglobin (Hb) reduction.
- The risk factors of AKI were increasing duration of surgery and reduced preoperative estimated glomerular filtration rate (GFR).
- This study emphasized the significant incidence of myocardial injury and AKI in the setting of EVAR.
- Majority of cases were asymptomatic and would likely go undetected without systematic monitoring. These findings warrant further prospective studies.
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