Effect of Volatile Anesthetics on Myocardial Infarction After Coronary Artery Surgery: A Post Hoc Analysis of a Randomized Trial

Imagem de Miniatura
Arquivos
art_ZANGRILLO_Effect_of_Volatile_Anesthetics_on_Myocardial_Infarction_After_2022.PDF (842.16 KB)
Citações na Scopus
9
Tipo de produção
article
Data de publicação
2022
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
W B SAUNDERS CO-ELSEVIER INC
Autores
ZANGRILLO, Alberto
LOMIVOROTOV, Vladimir V.
PASYUGA, Vadim V.
BELLETTI, Alessandro
GAZIVODA, Gordana
MONACO, Fabrizio
NETO, Caetano Nigro
LIKHVANTSEV, Valery V.
BRADIC, Nikola
LOZOVSKIY, Andrey
Citação
JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, v.36, n.8, p.2454-2462, 2022
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objective: To investigate the effect of volatile anesthetics on the rates of postoperative myocardial infarction (MI) and cardiac death after coronary artery bypass graft (CABG). Design: A post hoc analysis of a randomized trial. Setting: Cardiac surgical operating rooms. Participants: Patients undergoing elective, isolated CABG. Interventions: Patients were randomized to receive a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or total intravenous anesthesia (TIVA). The primary outcome was hemodynamically relevant MI (MI requiring high-dose inotropic support or prolonged intensive care unit stay) occurring within 48 hours from surgery. The secondary outcome was 1-year death due to cardiac causes. Measurements and Main Results: A total of 5,400 patients were enrolled between April 2014 and September 2017 (2,709 patients randomized to the volatile anesthetics group and 2,691 to TIVA). The mean age was 62 +/- 8.4 years, and the median baseline ejection fraction was 57% (50-67), without differences between the 2 groups. Patients in the volatile group had a lower incidence of MI with hemodynamic complications both in the per-protocol (14 of 2,530 [0.6%] v 27 of 2,501 [1.1%] in the TIVA group; p = 0.038) and as-treated analyses (16 of 2,708 [0.6%] v 29 of 2,617 [1.1%] in the TIVA group; p = 0.039), but not in the intention-to-treat analysis (17 of 2,663 [0.6%] v 28 of 2,667 [1.0%] in the TIVA group; p = 0.10). Overall, deaths due to cardiac causes were lower in the volatile group (23 of 2,685 [0.9%] v 40 of 2,668 [1.5%] than in the TIVA group; p = 0.03). Conclusions: An anesthetic regimen, including volatile agents, may be associated with a lower rate of postoperative MI with hemodynamic complication in patients undergoing CABG. Furthermore, it may reduce long-term cardiac mortality.
Palavras-chave
cardioprotection, mortality, myocardial infarction, cancer, cardiac surgery, volatile anesthetics
URI
https://observatorio.fm.usp.br/handle/OPI/49143
Referências
  1. Ahmad T, 2016, BRIT J ANAESTH, V117, P601, DOI 10.1093/bja/aew316
  2. Biancari F, 2018, J CARDIOTHORAC SURG, V13, DOI 10.1186/s13019-018-0710-0
  3. Bignami E, 2016, J CLIN MONIT COMPUT, V30, P347, DOI 10.1007/s10877-015-9725-4
  4. Bunte S, 2019, CRIT CARE MED, V47, pE250, DOI 10.1097/CCM.0000000000003629
  5. Byrne K, 2016, CAN J ANESTH, V63, P184, DOI 10.1007/s12630-015-0523-8
  6. Chioncel O, 2020, EUR J HEART FAIL, V22, P1315, DOI 10.1002/ejhf.1922
  7. Crescenzi G, 2004, EUR J CARDIO-THORAC, V25, P1001, DOI 10.1016/j.ejcts.2004.02.030
  8. De Hert S, 2009, ANAESTHESIA, V64, P953, DOI 10.1111/j.1365-2044.2009.06008.x
  9. Dubowitz JA, 2021, ANAESTHESIA, V76, P1198, DOI 10.1111/anae.15354
  10. Enlund M, 2019, CURR PHARM DESIGN, V25, P3028, DOI 10.2174/1381612825666190705184218
  11. Fernandez FG, 2019, ANN THORAC SURG, V108, P1625, DOI 10.1016/j.athoracsur.2019.09.034
  12. Ford I, 2016, NEW ENGL J MED, V375, P454, DOI 10.1056/NEJMra1510059
  13. Forget P, 2019, CANCERS, V11, DOI 10.3390/cancers11050592
  14. Franco RA, 2021, ANN INTENSIVE CARE, V11, DOI 10.1186/s13613-021-00808-6
  15. Garcia C, 2005, BRIT J ANAESTH, V94, P159, DOI 10.1093/bja/aei026
  16. Head SJ, 2013, EUR HEART J, V34, P2862, DOI 10.1093/eurheartj/eht330
  17. Head SJ, 2013, EUR HEART J, V34, P2873, DOI 10.1093/eurheartj/eht284
  18. Hernandez AF, 2009, AM HEART J, V158, P47, DOI 10.1016/j.ahj.2009.05.014
  19. Jammer I, 2015, EUR J ANAESTH, V32, P88, DOI 10.1097/EJA.0000000000000118
  20. Kastrup M, 2007, ACTA ANAESTH SCAND, V51, P347, DOI 10.1111/j.1399-6576.2006.01190.x
  21. Kunst G, 2015, ANAESTHESIA, V70, P467, DOI 10.1111/anae.12975
  22. Landoni G, 2013, BRIT J ANAESTH, V111, P886, DOI 10.1093/bja/aet231
  23. Landoni G, 2007, J CARDIOTHOR VASC AN, V21, P502, DOI 10.1053/j.jvca.2007.02.013
  24. Landoni G, 2019, NEW ENGL J MED, V380, P1214, DOI 10.1056/NEJMoa1816476
  25. Landoni G, 2018, J CARDIOTHOR VASC AN, V32, P225, DOI 10.1053/j.jvca.2017.06.017
  26. Landoni G, 2017, CONTEMP CLIN TRIALS, V59, P38, DOI 10.1016/j.cct.2017.05.011
  27. Landoni G, 2017, J CARDIOTHOR VASC AN, V31, P719, DOI 10.1053/j.jvca.2016.07.017
  28. Landry DW, 2001, NEW ENGL J MED, V345, P588, DOI 10.1056/NEJMra002709
  29. Likhvantsev VV, 2016, J CARDIOTHOR VASC AN, V30, P1221, DOI 10.1053/j.jvca.2016.02.030
  30. Lomivorotov VV, 2017, J CARDIOTHOR VASC AN, V31, P291, DOI 10.1053/j.jvca.2016.05.029
  31. Lotz C, 2015, J CARDIOTHOR VASC AN, V29, P749, DOI 10.1053/j.jvca.2014.11.012
  32. Monaco F, 2020, J CARDIOTHOR VASC AN, V34, P1622, DOI 10.1053/j.jvca.2020.02.038
  33. Moussa ID, 2013, J AM COLL CARDIOL, V62, P1563, DOI 10.1016/j.jacc.2013.08.720
  34. Pagel PS, 2018, J CARDIOTHOR VASC AN, V32, P1112, DOI 10.1053/j.jvca.2017.12.029
  35. Pagel PS, 2013, J CARDIOTHOR VASC AN, V27, P972, DOI 10.1053/j.jvca.2012.10.011
  36. Ridgeon E, 2016, CRIT CARE RESUSC, V18, P50
  37. Robinson N Bryce, 2021, J Thorac Cardiovasc Surg, DOI 10.1016/j.jtcvs.2021.05.052
  38. Rudiger A, 2009, SWISS MED WKLY, V139, P110, DOI smw-12446
  39. Sessler DI, 2019, LANCET, V394, P1807, DOI 10.1016/S0140-6736(19)32313-X
  40. Sponholz C, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0103996
  41. Thielmann M, 2017, EUR HEART J, V38, P2392, DOI 10.1093/eurheartj/ehx383
  42. Thygesen K, 2012, EUR HEART J, V33, P2551, DOI 10.1093/eurheartj/ehs184
  43. Uhlig C, 2016, ANESTHESIOLOGY, V124, P1230, DOI 10.1097/ALN.0000000000001120
  44. Vranckx P, 2020, EUR HEART J, V41, P4497, DOI 10.1093/eurheartj/ehaa617
  45. Wall T, 2019, BRIT J ANAESTH, V123, P135, DOI 10.1016/j.bja.2019.04.062
  46. Williams JB, 2011, J CARDIAC SURG, V26, P572, DOI 10.1111/j.1540-8191.2011.01301.x
  47. Yap A, 2019, CAN J ANESTH, V66, P546, DOI 10.1007/s12630-019-01330-x
  48. Yoo S, 2019, ANESTHESIOLOGY, V130, P31, DOI 10.1097/ALN.0000000000002491
  49. Zangrillo A, 2020, J CRIT CARE, V58, P89, DOI 10.1016/j.jcrc.2020.04.005

Coleções
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/08
Artigos e Materiais de Revistas Científicas - ODS/03