Myocardial Infarction Clinical Trial
Official title:
Ankle-Brachial Index Estimating Cardiac Complications After Non-Cardiac Surgery
Introduction: Patients undergoing noncardiac surgery are at increased risk of cardiovascular
complications. The development of methods that can accurately predict the occurrence of
these events is of critical importance and large studies have been published with this
purpose. Based on these studies, several algorithms have been proposed to predict of
cardiovascular events postoperatively. However, quantification of this risk is often
difficult to measure, especially in those patients with subclinical disease, not always
detected in routine evaluation. The ankle brachial index (ABI) has proved a valuable tool in
the quantification of cardiovascular risk, and perhaps the most promising when compared with
other methods. It is easy, cheap, fast and feasible in office care, with a great acceptance
between patients and small intra and inter observer variability. Despite strong evidence of
the utility of ABI as a tool in assessing cardiovascular risk, there are no data about the
use of ABI in other patients referred for non vascular surgery, which constitutes the
majority of operations performed worldwide.
Objectives: To evaluate the use of ABI as a predictor of cardiovascular events in patients
undergoing non-cardiac and non-vascular surgery and its applicability as a tool in the
reclassification of patient risk groups established by guidelines for perioperative
evaluation.
Methods: 300 moderate to high risk patients referred for non-vascular and non-cardiac will
be included. Data about risk factors, signs and symptoms, physical examination and treatment
used will be collected before surgery. The ABI will be measured and the patient will be
monitored for 30 days to the detection of cardiovascular events: death from any
cardiovascular causes, unstable angina, nonfatal myocardial infarction, isolated elevation
of troponin, decompensated heart failure, cardiogenic shock, stop nonfatal heart failure,
pulmonary edema, stroke and lower limb ischemia. Postoperative electrocardiogram, total
creatine kinase, MB fraction and troponin I will be measured daily until 3º day and whenever
clinically indicated.
n/a
Observational Model: Cohort, Time Perspective: Prospective
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