Zangrillo, Alberto and Lomivorotov, Vladimir V. and Pasyuga, Vadim V. and Belletti, Alessandro and Gazivoda, Gordana and Monaco, Fabrizio and Neto, Caetano Nigro and Likhvantsev, Valery V. and Bradic, Nikola and Lozovskiy, Andrey and Lei, Chong and Bukamal, Nazar A. R. and Silva, Fernanda Santos and Bautin, Andrey E. and Ma, Jun and Yong, Chow Yen and Carollo, Cristiana and Kunstyr, Jan and Wang, Chew Yin and Grigoryev, Evgeny and Riha, Hynek and Wang, Chengbin and El-Tahan, Mohamed R. and Scandroglio, Anna Mara and Mansor, Marzida and Lembo, Rosalba and Ponomarev, Dmitry N. and Bezerra, Francisco Jose Lucena and Ruggeri, Laura and Chernyavskiy, Alexander M. and Xu, Junmei and Tarasov, Dmitry G. and Navalesi, Paolo and Yavorovskiy, Andrey and Bove, Tiziana and Kuzovlev, Artem and Hajjar, Ludhmila A. and Landoni, Giovanni and Grp, MYRIAD Study (2022) Effect of Volatile Anesthetics on Myocardial Infarction After Coronary Artery Surgery: A Post Hoc Analysis of a Randomized Trial. Journal of Cardiothoracic and Vascular Anesthesia, 36 (8, A). pp. 2454-2462. ISSN 1053-0770, DOI https://doi.org/10.1053/j.jvca.2022.01.001.
Full text not available from this repository.Abstract
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. (C) 2022 Elsevier Inc. All rights reserved.
| Item Type: | Article |
|---|---|
| Funders: | Ministry of Health, Italy (RF-2010-2318290) |
| Uncontrolled Keywords: | cardioprotection; mortality; myocardial infarction; cancer; cardiac surgery; volatile anesthetics |
| Subjects: | R Medicine > RD Surgery |
| Divisions: | Faculty of Medicine > Anaesthesiology Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 17 Jan 2025 07:22 |
| Last Modified: | 17 Jan 2025 07:22 |
| URI: | http://eprints.um.edu.my/id/eprint/41700 |
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