Article of the Month – January 2020

Incidence and Predictors of Myocardial and Kidney Injury following Endovascular Aortic Repair: A Retrospective Cohort Study

URL:  https://link.springer.com/content/pdf/10.1007%2Fs12630-019-01438-0.pdf

DOI: 10.1007/s12630-019-01438-0

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

Article Description:

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)

Summary:

  • 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.

Check this interesting study and look for the results: would this be a plus or change your practice? 

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