Perioperative myocardial injury
Conditions
Interventions
Group 1: Myocardial damage defined by a significant increase in toponin I within 72 hours postoperatively. The exact timing of blood sampling and additional examinations is described in the study prot
Sponsors
Universitätsmedizin Göttingen
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Patients undergoing orthopaedic trauma surgery with medium to high surgical risk o Operations on the spine, hip joint replacement At least 1 risk factor for CMD o CMD risk factors: female gender, advanced age, arterial hypertension, obesity p.m., hyperlipidaemia, diabetes mellitus, chronic renal insufficiency, smoking. renal insufficiency, nicotine consumption.
Exclusion criteria
Exclusion criteria: - Age <18 years - Pregnancy and breastfeeding - Operations on patients with congenital heart defects - Operations on patients with long-term corticosteroid therapy - Patients with calcium antagonists and/or nitrates in prior medication - Emergency operations - Patients with cardiac devices and post heart valve replacement (regardless of MRI compatibility) - Patients with Raynaud's syndrome and/or PAD and/or vasculitis - Exclusion criteria due to contraindications for adenosine o Hypersensitivity to adenosine o AV block II. or III. degree (except for patients with a functioning pacemaker) o sick sinus syndrome o Atrial fibrillation or flutter; patients who have atrial fibrillation or flutter and an additional (accessory) conduction pathway between the atrium and ventricle may exhibit accelerated conduction and thus develop an increased ventricular rate o Chronic obstructive pulmonary disease with bronchospasm (e.g. bronchial asthma) o prolonged QT interval, regardless of whether this is congenital, induced by a substance or occurs as a result of a metabolic event, as torsade de pointes can be triggered o severe hypotension o decompensated heart failure o concomitant use with dipyridamole (due to up to 4-fold increase in the effect of adenosine)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Myocardial damage defined by a significant increase in toponin I within 72h postoperatively. | — |
Secondary
| Measure | Time frame |
|---|---|
| New or increasing diastolic dysfunction is screened for by means of TTE examination preoperatively and in the event of troponin I elevation. In addition, the occurrence of perioperative major adverse cardiovascular events (MACE; composite endpoint of acute myocardial infarction, acute heart failure, life-threatening cardiac arrhythmias and cardiovascular death) is clinically monitored. | — |
Countries
Germany
Contacts
Public ContactReiner Wäschle
Universitätsmedizin Göttingen
Outcome results
None listed