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Elevated cardiac troponin in the early post-operative period and mortality following ruptured abdominal aortic aneurysm: a retrospective population-based cohort study
Open accessAbstract
Introduction: Cardiac complications are potentially life-threatening following emergency repair of ruptured abdominal aortic aneurysms (rAAA). Our objectives were to describe the incidence, risk factors, cardiac outcomes and mortality associated with elevated cardiac-specific troponin (cTnI) following repair of rAAA. We hypothesized that early post-operative cTnI elevation (>0.15 mcg/L) in rAAA patients would identify a high-risk subgroup for cardiovascular complications and adverse outcomes. Methods: This was a retrospective population-based cohort study of all referrals for emergency repair of rAAA in central and northern Alberta, from 1 January 2002 to 31 December 2009. Demographic, clinical, physiologic and laboratory data were extracted, along with cardiac-specific investigations and events in the 72 hours following rAAA repair. Results: In total, 55% of patients (n = 77/141) had elevated cTnI, of which 12% (n = 9) had ST segment elevation, 23% (n = 18) had ST segment depression, 5% (n = 4) had other ECG changes, and 61% (n = 47) had no diagnostic ECG changes. Those with positive cTnI were more likely to have coronary artery disease (45.5% vs. 23.4%, P = 0.01) and higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores (24.9 vs. 21.4, n = 0.016). cTnI positive patients were more likely to receive vasoactive support (58.4% vs. 14.1%, P < 0.001), had longer intensive care unit (ICU) lengths of stay (8 (3 to 11) vs. 4 (2 to 9) days, P = 0.02) and higher adjusted in-hospital mortality (40.3% vs. 14.1%; OR 4.23; 95% CI, 1.47 to 12.1; P = 0.007). Conclusions: Elevated cTnI early after rAAA repair is an independent predictor for post-operative complications and death.
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Metadata
- Authors
- Kopolovic, I., Simmonds, K., Duggan, S., Ewanchuk, M., Stollery, D. E., & Bagshaw, S. M.
- Affiliations
- University of Alberta (CA)
- Alberta Health Services (CA)
- Corresponding author
- Bagshaw, Sean M
- Venue
- Critical Care
- Published
- 2012-08-07
- Volume
- 16
- Issue
- 4
- Pages
- R147-R147
- ISSN
- 1364-8535 (ISSN-L)
- PMC
- PMC3580736
- OpenAlex
- W1965304794
- Cited by
- 6
- References
- 1
- Citations by year
- 2023: 3 · 2022: 1 · 2013: 2
- FWCI
- 0.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Critical Care (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Alberta Innovates
- Topics
- Health Sciences › Medicine › Surgery › Aortic aneurysm repair treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Aortic Disease and Treatment Approaches
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Keywords
- cardiac troponin I, ruptured abdominal aortic aneurysm, postoperative cardiac complications, in-hospital mortality, ST-segment elevation, ST-segment depression, coronary artery disease, APACHE II score, vasoactive support, ICU length of stay, risk factors
- MeSH terms
- Adrenergic beta-Antagonists, Aged, Cardiovascular Diseases, Coronary Disease, Electrocardiography, Female, Heart, Humans, Hypertension, Intensive Care Units, Length of Stay, Male, Postoperative Complications, Postoperative Period, Retrospective Studies, Risk Factors, Ultrasonography, Biomarkers, Hospital Mortality, Aortic Aneurysm, Abdominal, Troponin I
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