Title
Parametri procene razvoja ranih kardiovaskularnih komplikacija kod rekonstrukcija velikih arterijskih krvnih sudova
Creator
Golubović, Mlađan D.
Copyright date
2018
Object Links
Select license
Autorstvo-Nekomercijalno-Bez prerade 3.0 Srbija (CC BY-NC-ND 3.0)
License description
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Language
Serbian
Cobiss-ID
Theses Type
Doktorska disertacija
description
Datum odbrane: 10.09.2018.
Other responsibilities
mentor
Perišić, Zoran
predsednik komisije
Pavlović, Svetlana
član komisije
Lađević, Nebojša
Academic Expertise
Medicinske nauke
University
Univerzitet u Nišu
Faculty
Medicinski fakultet
Group
Katedra za hirurgiju
Alternative title
Parmeters in the estimation of development of early cardiovascular complications after the reconstruction of large artrial blood vessels
Publisher
[M. D. Golubović]
Format
97 listova
description
Beleška o autoru: list 97;
Bibliografija: listovi 84-96.
description
Anesthesiology, reanimatology and intensive care
Abstract (en)
Introduction: Preoperative risk assessment for the development of cardiovascular
complications (CV) is an essential component in patients with open surgical
revascularization of multiple arterial vessels. The aim of this paper is to examine
whether biomarkers are of better prognostic capacity than clinical scores and whether
by analyzing their combinations we can get a model that can identify patients who are
at increased risk of developing CV complications during 90days after surgery.
Material and methods: The study was conducted as a prospective, observational
study involving 122 patients in 2017 at the Clinic for Cardiac Surgery at the Clinical
Center in Niš. The primary goal of monitoring patients is the development of
cardiovascular complications (sudden cardiac death, myocardial infarction, lung
edema, rhythm malignancies, unstable angina pectoris, acute cardiac decompensation).
Patients with cardiovascular events were a clinical group, while all patients with
cardiovascular complications were a control group. In this way, the design of the study
envisages a "nested case control" study.
Results: In the first three months, 29 patients (23.8%) had 50 cardiac complications.
Preoperative N-terminal natriuretic peptide (NT pro-BNP) was statistically
significantly higher in subjects who developed cardiac complications in the first three
months. Patients who have the Revised Cardiologic Risk Ratio (RCRI) values ≥3 have
a statistically significantly shorter time to develop cardiac complications in the first
month compared to other patients. The best discriminatory ability for cardiac
complications in the first three months has a combination of highly sensitive troponin I
(cTnI), NTproBNP and Vascular Physiological and Operative Severity Score for the
morphidity and morbidity (V-POSSUM). This model has high sensitivity and
specificity when it comes to assessment of cardiac complications in the first three
months.
Conclusion: Based on the results of the experimental and clinical part of the study, it
is concluded that the potential short-term assessment of cardiac complications is the
best joint application of clinical scores (RCRI, V-POSSUM and biochemical
parameters NTproBNP, cTnI). By applying these markers, patients can be classified
into certain risk categories, or a personalized approach to the patient can be applied to
a certain extent.
Authors Key words
procena rizika, kardiovaskularne komplikacije, klinički skorovi,
biomarkeri
Authors Key words
risk estimation, cardiovascular complication, clinical scores,
biomarkers
Classification
616.13-089.168-06:616-089.5(043.3)
Subject
B 590
Type
Tekst
Abstract (en)
Introduction: Preoperative risk assessment for the development of cardiovascular
complications (CV) is an essential component in patients with open surgical
revascularization of multiple arterial vessels. The aim of this paper is to examine
whether biomarkers are of better prognostic capacity than clinical scores and whether
by analyzing their combinations we can get a model that can identify patients who are
at increased risk of developing CV complications during 90days after surgery.
Material and methods: The study was conducted as a prospective, observational
study involving 122 patients in 2017 at the Clinic for Cardiac Surgery at the Clinical
Center in Niš. The primary goal of monitoring patients is the development of
cardiovascular complications (sudden cardiac death, myocardial infarction, lung
edema, rhythm malignancies, unstable angina pectoris, acute cardiac decompensation).
Patients with cardiovascular events were a clinical group, while all patients with
cardiovascular complications were a control group. In this way, the design of the study
envisages a "nested case control" study.
Results: In the first three months, 29 patients (23.8%) had 50 cardiac complications.
Preoperative N-terminal natriuretic peptide (NT pro-BNP) was statistically
significantly higher in subjects who developed cardiac complications in the first three
months. Patients who have the Revised Cardiologic Risk Ratio (RCRI) values ≥3 have
a statistically significantly shorter time to develop cardiac complications in the first
month compared to other patients. The best discriminatory ability for cardiac
complications in the first three months has a combination of highly sensitive troponin I
(cTnI), NTproBNP and Vascular Physiological and Operative Severity Score for the
morphidity and morbidity (V-POSSUM). This model has high sensitivity and
specificity when it comes to assessment of cardiac complications in the first three
months.
Conclusion: Based on the results of the experimental and clinical part of the study, it
is concluded that the potential short-term assessment of cardiac complications is the
best joint application of clinical scores (RCRI, V-POSSUM and biochemical
parameters NTproBNP, cTnI). By applying these markers, patients can be classified
into certain risk categories, or a personalized approach to the patient can be applied to
a certain extent.
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