Perioperative Research Group, Department of Anaesthetics, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
Curr Opin Anaesthesiol. 2014 Jun;27(3):336-43. doi: 10.1097/ACO.0000000000000071.
To review the current evidence for detection and management of perioperative myocardial ischemia.
Patients who sustain a myocardial injury after noncardiac surgery are predominantly asymptomatic. Myocardial injury after noncardiac surgery is associated with both short-term and long-term mortality. Mortality from both cardiac and noncardiac causes is significant.
Perioperative physicians should refrain from the use of nonsurgical diagnostic criteria for myocardial infarction and adopt the clinical entity known as myocardial injury after noncardiac surgery in order to allow for better determination of the prevalence of this perioperative complication. Studies should focus on establishing the feasibility of broad postoperative troponin surveillance following noncardiac surgery. Clinical trials of potential therapies for myocardial injury after noncardiac surgery are urgently needed.
审查围手术期心肌缺血的检测和处理的现有证据。
非心脏手术后发生心肌损伤的患者主要是无症状的。非心脏手术后的心肌损伤与短期和长期死亡率相关。心脏和非心脏原因导致的死亡率都很高。
围手术期医生应避免使用非手术性心肌梗死诊断标准，采用非心脏手术后已知的心肌损伤临床实体，以便更好地确定这种围手术期并发症的发生率。研究应侧重于确定非心脏手术后广泛的术后肌钙蛋白监测的可行性。迫切需要对非心脏手术后心肌损伤的潜在治疗进行临床试验。
