Myocardial Ischemia
Conditions
Interventions
This is a prospective observational single center cohort study, with no experimental therapeutic intervention, no randomization, no masking, and no placebo, with consecutive recruitment over twenty fo
Sponsors
Hospital Israelita Albert Einstein
Hospital Israelita Albert Einstein
Eligibility
Age
45 Years to No maximum
Inclusion criteria
Inclusion criteria: Patients with cancer under active treatment (active oncologic disease); undergoing elective, urgent, or emergency noncardiac surgery requiring general anesthesia; admitted to the intensive care unit in the postoperative period; classified as intermediate- or high-risk surgical candidates at preoperative outpatient assessment, defined as Revised Cardiac Risk Index (Lee score) > 2 or moderate-or-higher risk of cardiac complications according to the ACS-NSQIP calculator; or, in the absence of formal preoperative evaluation, age > 65 years or age > 45 years plus at least one cardiovascular risk factor (peripheral arterial disease, coronary artery disease, prior stroke, diabetes mellitus, or systemic arterial hypertension).
Exclusion criteria
Exclusion criteria: Patients younger than 45 years; refusal to participate by the patient or their legal representative; troponin elevation attributable to a non-ischemic cause, according to predefined protocol criteria (e.g., pulmonary embolism, myocarditis, tachyarrhythmias); patients undergoing more than one noncardiac surgery within the same calendar year.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Occurrence of myocardial injury after noncardiac surgery, defined as at least one cardiac troponin value above the assay-specific 99th-percentile upper reference limit or an increase of 50 percent or more from the preoperative value, measured by automated serum cardiac troponin assay within the first 72 hours after the end of surgery. | — |
Secondary
| Measure | Time frame |
|---|---|
| Hospital length of stay, in days, measured from the date of surgery to hospital discharge or death, obtained from medical records; incidence of major cardiovascular events within 30 days after surgery, defined as a composite of non-fatal stroke, acute myocardial infarction, or cardiovascular death, assessed through review of medical records and standardized telephone interviews on days 7 and 30 after study inclusion; intensive care unit mortality up to ICU discharge, verified in the medical record; in-hospital mortality up to hospital discharge, verified in the medical record; 30-day mortality after study inclusion, assessed by telephone contact and review of hospital records. | — |
Countries
Brazil
Contacts
Public ContactRafael Melo
Hospital Israelita Albert Einstein
Outcome results
None listed