Critical Pathways in Cardiology最新文献

{"title":"Impact of Baseline Estimated Glomerular Filtration Rate Using CKD-EPI Equation on Long-term Prognosis of STEMI Patients: A Matter of Small Increments!","authors":"Seyed-Ali Sadre-Bafghi,&nbsp;Mehrnaz Mohebi,&nbsp;Fatemeh Hadi,&nbsp;Hanieh Parsaiyan,&nbsp;Mohammadreza Memarjafari,&nbsp;Roya Tayeb,&nbsp;Saeed Ghodsi,&nbsp;Reza Sheikh-Sharbafan,&nbsp;Hamidreza Poorhosseini,&nbsp;Mojtaba Salarifar,&nbsp;Mohammad Alidoosti,&nbsp;Ali-Mohammad Haji-Zeinali,&nbsp;Alireza Amirzadegan,&nbsp;Hassan Aghajani,&nbsp;Yaser Jenab,&nbsp;Zahra Hosseini","doi":"10.1097/HPC.0000000000000296","DOIUrl":"https://doi.org/10.1097/HPC.0000000000000296","url":null,"abstract":"<p><strong>Background: </strong>Baseline biomarkers including glomerular filtration rate (GFR) guide the management of patients with ST-segment elevation myocardial infarction (STEMI). GFR is a tool for prediction of adverse outcomes in these patients.</p><p><strong>Objectives: </strong>We aimed to determine the prognostic utility of estimated GFR using Chronic Kidney Disease Epidemiology Collaboration in a cohort of STEMI patients.</p><p><strong>Methods: </strong>A retrospective cohort was designed among 5953 patients with STEMI. Primary endpoint of the study was major adverse cardiovascular events. GFR was classified into 3 categories delineated as C1 (<60 mL/min), C2 (60-90), and C3 (≥ 90).</p><p><strong>Results: </strong>Mean age of the patients was 60.38 ± 5.54 years and men constituted 78.8% of the study participants. After a median of 22 months, Multivariate Cox-regression demonstrated that hazards of major averse cardiovascular event, all-cause mortality, cardiovascular mortality, and nonfatal myocardial infarction were significantly lower for subjects in C3 as compared with those in C1. Corresponding hazard ratios (HRs) for mentioned outcomes regarding C3 versus C1 were (95% confidence interval) were (HR = 0.852 [0.656-0.975]; P = 0.035), (HR = 0.425 [0.250-0.725]; P = 0.002), (HR = 0.425 [0.242-0.749]; P = 0.003), and (0.885 [0.742-0.949]; P = 0.003), respectively. Normal GFR was also associated with declined in-hospital mortality with HR of C3 versus C1: 0.299 (0.178-0.504; P < 0.0001).</p><p><strong>Conclusions: </strong>Baseline GFR via Chronic Kidney Disease Epidemiology Collaboration is associated with long-term cardiovascular outcomes following STEMI.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":"21 3","pages":"153-159"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10259823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Care Pathway for Atrial Fibrillation Patients in the Emergency Department.","authors":"Duc H Do,&nbsp;Breno Bernardes-Souza,&nbsp;Michael Merjanian,&nbsp;Brandan Lombardo,&nbsp;David M Donaldson,&nbsp;Lynnell B McCullough,&nbsp;Noel G Boyle,&nbsp;Richelle J Cooper","doi":"10.1097/HPC.0000000000000289","DOIUrl":"https://doi.org/10.1097/HPC.0000000000000289","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is the most common cardiac arrhythmia and its prevalence is continuously increasing in the United States, leading to a progressive rise in the number of disease-related emergency department (ED) visits and hospitalizations. Although optimal long-term outpatient management for AF is well defined, the guidelines for optimal ED management of acute AF episodes is less clear. Studies have demonstrated that discharging patients with AF from the ED after acute stabilization is both safe and cost effective; however, the majority of these patients in the United States and in our institution are admitted to the hospital. To improve care of these patients, we established a multidisciplinary collaboration to develop an evidence-based systematic approach for the treatment and management of AF in the ED, that led to the creation of the University of California-Cardioversion, Anticoagulation, Rate Control, Expedited Follow-up/Education Atrial Fibrillation Pathway. Our pathway focuses on the acute stabilization of AF, adherence to best practices for anticoagulation, and reduction in unnecessary admissions through discharge from the ED with expedited outpatient follow-up whenever safe. A novel aspect of our pathway is that it is primarily driven by the ED physicians, while other published protocols primarily involve consulting cardiologists to guide management in the ED. Our protocol is very pertinent considering the current trend toward increased AF prevalence in the United States, coupled with a need for widespread implementation of strategies aimed at improving management of these patients while safely reducing hospital admissions and the economic burden of AF.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":" ","pages":"105-113"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40631654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing a Cardiac ICU Recovery Clinic: Characterizing a Model for Continuity of Cardiac Critical Care.","authors":"Hoyle L Whiteside,&nbsp;Dustin Hillerson,&nbsp;Victoria Buescher,&nbsp;Kayla Kreft,&nbsp;Kirby P Mayer,&nbsp;Ashley Montgomery-Yates,&nbsp;Vedant A Gupta","doi":"10.1097/HPC.0000000000000294","DOIUrl":"https://doi.org/10.1097/HPC.0000000000000294","url":null,"abstract":"<p><strong>Background: </strong>Care in the cardiovascular intensive care unit (CICU) has become increasingly intricate due to a temporal rise in noncardiac diagnoses and overall clinical complexity with high risk for short-term rehospitalization and mortality. Survivors of critical illness are often faced with debility and limitations extending beyond the index hospitalization. Comprehensive ICU recovery programs have demonstrated some efficacy but have primarily targeted survivors of acute respiratory distress syndrome or sepsis. The efficacy of dedicated ICU recovery programs on the CICU population is not defined.</p><p><strong>Methods: </strong>We aim to describe the design and initial experience of a novel CICU-recovery clinic (CICURC). The primary outcome was death or rehospitalization in the first 30 days following hospital discharge. Self-reported outcome measures were performed to assess symptom burden and independence in activities of daily living.</p><p><strong>Results: </strong>Using standardized criteria, 41 patients were referred to CICURC of which 78.1% established care and were followed for a median of 88 (56-122) days. On intake, patients reported a high burden of heart failure symptoms (KCCQ overall summary score 29.8 [18.0-47.5]), and nearly half (46.4%) were dependent on caretakers for activities of daily living. Thirty days postdischarge, no deaths were observed and the rate of rehospitalization for any cause was 12.2%.</p><p><strong>Conclusions: </strong>CICU survivors are faced with significant residual symptom burden, dependence upon caretakers, and impairments in mental health. Dedicated CICURCs may help prioritize treatment of ICU related illness, reduce symptom burden, and improve outcomes. Interventions delivered in ICU recovery clinic for patients surviving the CICU warrant further investigation.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":" ","pages":"135-140"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40647611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Pulmonary Emboli Management Between Pulmonary Emboli Response Team and the Conventional Method: The First Study From Iran.","authors":"Mohammad Hadi Mansouri,&nbsp;Farid Esmaeili,&nbsp;Alireza Khosravi,&nbsp;Pejman Mansouri,&nbsp;Mohsen Mirmohammadsadeghi,&nbsp;Hooman Dehghan,&nbsp;Mana Jameie,&nbsp;Afshin Amirpour,&nbsp;Reihaneh Zavar","doi":"10.1097/HPC.0000000000000279","DOIUrl":"https://doi.org/10.1097/HPC.0000000000000279","url":null,"abstract":"<p><strong>Background: </strong>We aimed to evaluate the effectiveness of the Pulmonary Embolism Response Team (PERT) for intermediate-high risk and high-risk pulmonary embolism (PE) patients.</p><p><strong>Methods: </strong>This single-blind clinical trial was performed in 2019-2021, evaluating patients with intermediate-high risk and high risk of PE. Patients in the intervention group were managed by the PERT team, and treatment plans were implemented as soon as possible. Patients in the other group received conventional PE treatments based on the hospital protocols. We compared the primary outcome of short-term mortality between the 2 groups and secondary outcomes, including right ventricle indices, hospital length-of-stay, time to decision, 30-day and in-hospital bleeding.</p><p><strong>Results: </strong>Data of 74 patients were analyzed. We found no significant differences between the 2 groups regarding short-term mortality (P = 0.642), bleeding, and other complications. However, the length-of-stay and time to decision were significantly lower in patients treated by the PERT team (P < 0.001 for both). Further evaluations revealed that patients in the intervention group had a more significant reduction in the right ventricle size and systolic pulmonary pressure compared with the control group (P = 0.015, P = 0.039, respectively). In addition, tricuspid annular plane systolic excursion and fractional area change increased more in the intervention group (P = 0.023, P = 0.016, respectively).</p><p><strong>Conclusions: </strong>The PERT team led to significantly less time to make decisions, and it was able to select patients for advanced treatments more appropriately. Due to these facts, patients treated by PERT had significantly lower hospitalization duration and better right ventricle indices compared to controls.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":"21 2","pages":"61-66"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10207548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Patient Pathway Review for Atrial Fibrillation.","authors":"Chun Shing Kwok,&nbsp;Gregory Y H Lip","doi":"10.1097/HPC.0000000000000280","DOIUrl":"https://doi.org/10.1097/HPC.0000000000000280","url":null,"abstract":"<p><p>The care pathway for patients with atrial fibrillation (AF) is variable and this variability is explored in a patient pathway review. This review describes events that may take place for a patient with AF considering the \"ideal\" and the \"real-world\" pathway and attempts to rationalize them by considering the patient, clinician, health service, and societal perspective. In the \"ideal\" pathway, AF in a patient is either identify before or after stroke. The \"real-world\" pathway introduces the concepts that symptoms may influence patient decision-making to seek help, AF may be identified incidentally, and healthcare professionals may fail to identify AF. The management of AF includes no treatment or treatment such as stroke prevention, rate or rhythm control, and comorbidity management. The overall outcomes for patient depend on the presence of symptoms and response to therapies. The two major priorities for patients are symptomatic relief and avoidance of stroke. While most clinicians will find that initial AF management is not challenging but there may be incidental opportunities for earlier identification. From the healthcare service perspective, noncardiologists and cardiologists care for patients with AF, which results in much heterogeneity management. From the societal perspective, the burden of AF is significant resulting in substantial cost from hospitalizations and treatments. People with AF can take on different paths, which depend on factors related to the patient's decision-making, clinical decision-making, and patient's response to the treatment. A streamlined approach to a holistic and integrated care pathway approach to AF management is needed.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":"21 2","pages":"96-102"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10259779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician Perception of Risk As a Barrier to Implementation of a High-sensitivity Troponin Accelerated Diagnostic Protocol.","authors":"Andrew J Matuskowitz,&nbsp;John P Hall,&nbsp;Mathew J Gregoski,&nbsp;Steven H Saef","doi":"10.1097/HPC.0000000000000287","DOIUrl":"https://doi.org/10.1097/HPC.0000000000000287","url":null,"abstract":"<p><strong>Background: </strong>To assess emergency department (ED) clinician perception of patient risk, we measured willingness to discharge patients categorized as increased risk by traditional risk stratification modalities for acute coronary syndrome but low risk by a validated high-sensitivity troponin accelerated diagnostic protocol (HST-ADP).</p><p><strong>Methods: </strong>This was a cross-sectional descriptive survey study distributed to ED clinicians at an urban academic medical center. Four clinical vignettes classified hypothetical patients as low risk for 30-day acute coronary syndrome according to the 0-/1-hour HST-ADP. Vignettes additionally identified patients with History, Electrocardiogram, Age, Risk factors, and initial Troponin (HEART) scores of 4 or 6 (2 cases each). One patient in each subset had preexisting coronary artery disease (CAD). ED clinicians self-reported willingness to discharge patients from the ED on a 10-point Likert scale.</p><p><strong>Results: </strong>Among 66 eligible participants, 36 (55%) participated in the survey. ED clinicians reported a mean willingness to discharge patients of 6.07 (95% confidence interval, 5.34-6.80). They reported higher mean willingness to discharge patients with HEART scores of 4 compared with those with HEART scores of 6 (mean difference, 3.61; 95% confidence interval, 2.19-5.03). There were no differences in willingness to discharge regarding presence or absence of CAD or between clinician types (attending, resident, advanced practice provider).</p><p><strong>Conclusions: </strong>ED clinicians accustomed to the HEART Pathway demonstrated limited willingness to discharge patients from the ED categorized as moderate risk by the HEART score despite simultaneous classification as low risk by the 0-/1-hour HST-ADP. Willingness to discharge was higher with lower HEART scores but not affected by the presence of CAD and did not vary between clinician types.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":"21 2","pages":"73-76"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10309064/pdf/nihms-1905710.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10205517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning to Assess for Acute Myocardial Infarction Within 30 Minutes.","authors":"James McCord,&nbsp;Joseph Gibbs,&nbsp;Michael Hudson,&nbsp;Michele Moyer,&nbsp;Gordon Jacobsen,&nbsp;Gillian Murtagh,&nbsp;Richard Nowak","doi":"10.1097/HPC.0000000000000281","DOIUrl":"https://doi.org/10.1097/HPC.0000000000000281","url":null,"abstract":"<p><p>Variations in high-sensitivity cardiac troponin I by age and sex along with various sampling times can make the evaluation for acute myocardial infarction (AMI) challenging. Machine learning integrates these variables to allow a more accurate evaluation for possible AMI. The goal was to test the diagnostic and prognostic utility of a machine learning algorithm in the evaluation of possible AMI. We applied a machine learning algorithm (myocardial-ischemic-injury-index [MI3]) that incorporates age, sex, and high-sensitivity cardiac troponin I levels at time 0 and 30 minutes in 529 patients evaluated for possible AMI in a single urban emergency department. MI3 generates an index value from 0 to 100 reflecting the likelihood of AMI. Patients were followed at 30-45 days for major adverse cardiac events (MACEs). There were 42 (7.9%) patients that had an AMI. Patients were divided into 3 groups by the MI3 score: low-risk (≤ 3.13), intermediate-risk (> 3.13-51.0), and high-risk (> 51.0). The sensitivity for AMI was 100% with a MI3 value ≤ 3.13 and 353 (67%) ruled-out for AMI at 30 minutes. At 30-45 days, there were 2 (0.6%) MACEs (2 noncardiac deaths) in the low-risk group, in the intermediate-risk group 4 (3.0%) MACEs (3 AMIs, 1 cardiac death), and in the high-risk group 4 (9.1%) MACEs (4 AMIs, 2 cardiac deaths). The MI3 algorithm had 100% sensitivity for AMI at 30 minutes and identified a low-risk cohort who may be considered for early discharge.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":"21 2","pages":"67-72"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10205495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The E/e' Ratio: As \"Critical\" As the Left Ventricular Ejection Fraction?","authors":"Mori J Krantz,&nbsp;Todd Rudo,&nbsp;Blaine Horvath,&nbsp;Elizabeth Gregory,&nbsp;Morteza Farasat,&nbsp;Odette Gore,&nbsp;Philip S Mehler","doi":"10.1097/HPC.0000000000000288","DOIUrl":"https://doi.org/10.1097/HPC.0000000000000288","url":null,"abstract":"<p><p>Ascertainment of the left ventricular ejection fraction is the primary reason for ordering echocardiography in the acute care setting; however, this parameter does not provide information regarding a patient's volume status. As such, it cannot be reliably used to inform decisions regarding intravenous fluid resuscitation or diuresis, particularly in undifferentiated dyspnea and hypotension. This is relevant given a national quality improvement exhortation to provide aggressive fluid resuscitation as part of a \"sepsis bundle.\" This initiative must be tempered by the well-established increase in hospital mortality from providing intravenous fluid to patients with unrecognized heart failure, which may occur if sepsis is misdiagnosed. We describe herein, what is to our knowledge, the first description of a critically elevated Doppler ratio of mitral inflow peak E-wave velocity to the mean mitral annular velocity as a harbinger of sudden death from pulmonary edema in a patient treated with aggressive intravenous fluids as part of the \"sepsis bundle.\" This is utilized as a springboard for proposing a clinical algorithm focused on expedited echocardiography. It emphasized the potential value of advancing markedly the diastolic assessment of filling pressure (ratio of mitral inflow peak E-wave velocity to the mean mitral annular velocity) in the acute care setting to a level of import comparable to the left ventricular ejection fraction.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":"21 2","pages":"93-95"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10207565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a Risk Prediction Model for Early Atrial Fibrillation Recurrence After Maze Procedure.","authors":"Amirhosein Seyedhoseinpour,&nbsp;Ali Vasheghani-Farahani,&nbsp;Kyomars Abbasi,&nbsp;Arash Jalali,&nbsp;Farbod Zahed Tajreshi,&nbsp;Amir Fazeli,&nbsp;Seyyed Mojtaba Ghorashi,&nbsp;Negar Omidi","doi":"10.1097/HPC.0000000000000286","DOIUrl":"https://doi.org/10.1097/HPC.0000000000000286","url":null,"abstract":"<p><strong>Background: </strong>The efficiency of maze is a safe procedure in AF patients who underwent concomitant mitral valve surgery was more than 60%. The aim of this study was to define predictors of early AF recurrence after concomitant maze procedure with valvular surgery.</p><p><strong>Methods: </strong>In this retrospective study, 234 patients with AF underwent concomitant valvular replacement and maze procedure. Patients were classified into 2 groups of sinus and atrial fibrillation (AF). Baseline characteristics of patients were then compared between 2 groups.</p><p><strong>Results: </strong>Totally, 234 patients were enrolled, 148 of which maintained sinus rhythm during hospitalization. Left atrial diameter and type of valvular surgery were similar in both groups. Age, number of replaced valves, concomitant coronary artery bypass grafting, and history of preoperative persistent AF and beta-blocker therapy were independent predictors of in-hospital AF recurrence. We used these variables to build a model to anticipate early AF recurrence.</p><p><strong>Conclusions: </strong>Being older, multivalvular surgery, and persistent preoperative AF were the predictors of higher risk of early recurrent AF, whereas concomitant coronary artery bypass grafting and using beta-blocker had a protective effect. This model based on preoperative and operative characteristics can help us to better evaluate if the patient benefits from maze procedure coincide with valvular surgery.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":"21 2","pages":"77-83"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Very Low Risk for In-hospital Adverse Outcome Such as ST-elevation or Non-ST-elevation Myocardial Infarction in Patients Undergoing Knee Surgery.","authors":"Armin Talle,&nbsp;Mehrtash Hashemzadeh,&nbsp;Mohammad Reza Movahed","doi":"10.1097/HPC.0000000000000282","DOIUrl":"https://doi.org/10.1097/HPC.0000000000000282","url":null,"abstract":"<p><strong>Background: </strong>Knee surgery is a very common surgery. The risk of cardiac events is thought to be low. The goal of this study was to evaluate inpatients adverse outcomes such as ST-elevation myocardial infarction (STEMI) or Non-ST-elevation myocardial infarction in patients undergoing knee surgery.</p><p><strong>Method: </strong>Using the nation inpatient sample database, we evaluated the occurrence of STEMI and Non-STEMI in a very large population.</p><p><strong>Results: </strong>Using 2 random samples from 2005 to 2014, 10 years apart involving 7444 knee surgeries, the occurrence of STEMI and Non-STEMI were very low. In 2005, only 1 STEMI (0.0%) and 4 non-STEMI (0.1%) events occurred in inpatient knee-surgery patients. In the 2014 group, 0 STEMI (0.0%) and 5 non-STEMI (0.16%) events occurred in inpatient knee-surgery patients. Overall, STEMI or non-STEMI events occurred in 0.13% of inpatient knee-surgery procedures.</p><p><strong>Conclusions: </strong>Inpatients' adverse outcome of patients undergoing knee surgery is very low suggesting that extensive cardiac workup for knee surgery may not be warranted.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":"21 2","pages":"84-86"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10205502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}