围手术期心肌梗死和损伤。

IF 3.9 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS European Heart Journal: Acute Cardiovascular Care Pub Date : 2024-05-28 DOI:10.1093/ehjacc/zuae014
Marco Spagnolo, Giovanni Occhipinti, Claudio Laudani, Antonio Greco, Davide Capodanno
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引用次数: 0

摘要

与心脏和非心脏手术相关的围手术期心肌梗死(PMI)和损伤在临床实践中得到越来越多的认可。随着时间的推移,在接受冠状动脉血运重建术的患者群体中,诊断 PMI 的各种定义已经形成并得到验证。然而,定义的多样性给临床工作带来了巨大挑战,也使临床试验的设计和解释变得更加复杂。准确诊断 PMI 的必要性激发了人们对建立普遍接受且对预后有意义的心脏生物标志物升高阈值和支持性辅助标准的极大兴趣。事实上,根据心肌梗死的第四个通用定义,心脏生物标志物的升高已被广泛证实与死亡率和心血管事件的增加有关。在经导管主动脉瓣植入术等非冠状动脉心脏手术中,人们越来越认识到 PMI 的高发病率及其对患者预后的不利影响。同样,新出现的研究强调了 PMI 和损伤在非心脏手术中的重要性,凸显了在这一领域迫切需要有效的预防和风险管理策略。
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Periprocedural myocardial infarction and injury.

Periprocedural myocardial infarction (PMI) and injury, pertinent to both cardiac and non-cardiac procedures, have gained increasing recognition in clinical practice. Over time, diverse definitions for diagnosing PMI have been developed and validated among patient populations undergoing coronary revascularization. However, this variety in definitions presents considerable challenges in clinical settings and complicates both the design and interpretation of clinical trials. The necessity to accurately diagnose PMI has spurred significant interest in establishing universally accepted and prognostically meaningful thresholds for cardiac biomarkers elevation and supportive ancillary criteria. In fact, elevations in cardiac biomarkers in line with the 4th Universal Definition of Myocardial Infarction, have been extensively confirmed to be associated with increased mortality and cardiovascular events. In the context of non-coronary cardiac procedures, such as Transcatheter Aortic Valve Implantation, there is a growing acknowledgment of both the high incidence rates and the adverse impact of PMI on patient outcomes. Similarly, emerging research underscores the significance of PMI and injury in non-cardiac surgery, highlighting the urgent need for effective prevention and risk management strategies in this domain.

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来源期刊
CiteScore
8.50
自引率
4.90%
发文量
325
期刊介绍: The European Heart Journal - Acute Cardiovascular Care (EHJ-ACVC) offers a unique integrative approach by combining the expertise of the different sub specialties of cardiology, emergency and intensive care medicine in the management of patients with acute cardiovascular syndromes. Reading through the journal, cardiologists and all other healthcare professionals can access continuous updates that may help them to improve the quality of care and the outcome for patients with acute cardiovascular diseases.
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