Coronary artery bypass surgery perioperative management of myocardial ischemia: Difference between revisions

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(/* ACCF/AHA Guidelines for Preconditioning/Management of Myocardial Ischemia{{cite journal| author=Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG et al.| title=2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A Repo)
(/* ACCF/AHA Guidelines for Preconditioning/Management of Myocardial Ischemia{{cite journal| author=Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG et al.| title=2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A Repo)
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===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]===
===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]===
'''1.''' The effectiveness of prophylactic pharmacological therapies or controlled reperfusion strategies aimed at inducing preconditioning or attenuating the adverse consequences of myocardial reperfusion injury or surgically induced systemic inflammation is uncertain. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''
'''1.''' The effectiveness of prophylactic pharmacological therapies or controlled reperfusion strategies aimed at inducing preconditioning or attenuating the adverse consequences of myocardial reperfusion injury or surgically induced systemic inflammation is uncertain.<ref name="pmid20548978">{{cite journal| author=Rabi D, Clement F, McAlister F, Majumdar S, Sauve R, Johnson J et al.| title=Effect of perioperative glucose-insulin-potassium infusions on mortality and atrial fibrillation after coronary artery bypass grafting: a systematic review and meta-analysis. | journal=Can J Cardiol | year= 2010 | volume= 26 | issue= 6 | pages= 178-84 | pmid=20548978 | doi= | pmc=PMC2903988 | url= }} </ref><ref name="pmid20416890">{{cite journal| author=Buckberg GD| title=Controlled reperfusion after ischemia may be the unifying recovery denominator. | journal=J Thorac Cardiovasc Surg | year= 2010 | volume= 140 | issue= 1 | pages= 12-8, 18.e1-2 | pmid=20416890 | doi=10.1016/j.jtcvs.2010.02.014 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20416890  }} </ref><ref name="pmid18381567">{{cite journal| author=MEND-CABG II Investigators. Alexander JH, Emery RW, Carrier M, Ellis SJ, Mehta RH et al.| title=Efficacy and safety of pyridoxal 5'-phosphate (MC-1) in high-risk patients undergoing coronary artery bypass graft surgery: the MEND-CABG II randomized clinical trial. | journal=JAMA | year= 2008 | volume= 299 | issue= 15 | pages= 1777-87 | pmid=18381567 | doi=10.1001/jama.299.15.joc80027 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18381567  }} </ref><ref name="pmid9002496">{{cite journal| author=Mangano DT| title=Effects of acadesine on myocardial infarction, stroke, and death following surgery. A meta-analysis of the 5 international randomized trials. The Multicenter Study of Perioperative Ischemia (McSPI) Research Group. | journal=JAMA | year= 1997 | volume= 277 | issue= 4 | pages= 325-32 | pmid=9002496 | doi= | pmc= | url= }} </ref><ref name="pmid16814669">{{cite journal| author=Mangano DT, Miao Y, Tudor IC, Dietzel C, Investigators of the Multicenter Study of Perioperative Ischemia (McSPI) Research Group. Ischemia Research and Education Foundation (IREF)| title=Post-reperfusion myocardial infarction: long-term survival improvement using adenosine regulation with acadesine. | journal=J Am Coll Cardiol | year= 2006 | volume= 48 | issue= 1 | pages= 206-14 | pmid=16814669 | doi=10.1016/j.jacc.2006.04.044 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16814669  }} </ref><ref name="pmid14992903">{{cite journal| author=Shernan SK, Fitch JC, Nussmeier NA, Chen JC, Rollins SA, Mojcik CF et al.| title=Impact of pexelizumab, an anti-C5 complement antibody, on total mortality and adverse cardiovascular outcomes in cardiac surgical patients undergoing cardiopulmonary bypass. | journal=Ann Thorac Surg | year= 2004 | volume= 77 | issue= 3 | pages= 942-9; discussion 949-50 | pmid=14992903 | doi=10.1016/j.athoracsur.2003.08.054 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14992903  }} </ref><ref name="pmid20880552">{{cite journal| author=Smith PK, Shernan SK, Chen JC, Carrier M, Verrier ED, Adams PX et al.| title=Effects of C5 complement inhibitor pexelizumab on outcome in high-risk coronary artery bypass grafting: combined results from the PRIMO-CABG I and II trials. | journal=J Thorac Cardiovasc Surg | year= 2011 | volume= 142 | issue= 1 | pages= 89-98 | pmid=20880552 | doi=10.1016/j.jtcvs.2010.08.035 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20880552  }} </ref><ref name="pmid18954626">{{cite journal| author=Testa L, Van Gaal WJ, Bhindi R, Biondi-Zoccai GG, Abbate A, Agostoni P et al.| title=Pexelizumab in ischemic heart disease: a systematic review and meta-analysis on 15,196 patients. | journal=J Thorac Cardiovasc Surg | year= 2008 | volume= 136 | issue= 4 | pages= 884-93 | pmid=18954626 | doi=10.1016/j.jtcvs.2007.12.062 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18954626  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''


'''2.''' Mechanical preconditioning might be considered to reduce the risk of perioperative myocardial ischemia and infarction in patients undergoing off-pump CABG. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''
'''2.''' Mechanical preconditioning might be considered to reduce the risk of perioperative myocardial ischemia and infarction in patients undergoing off-pump CABG.<ref name="pmid11948051">{{cite journal| author=Laurikka J, Wu ZK, Iisalo P, Kaukinen L, Honkonen EL, Kaukinen S et al.| title=Regional ischemic preconditioning enhances myocardial performance in off-pump coronary artery bypass grafting. | journal=Chest | year= 2002 | volume= 121 | issue= 4 | pages= 1183-9 | pmid=11948051 | doi= | pmc= | url= }} </ref><ref name="pmid12683571">{{cite journal| author=Penttilä HJ, Lepojärvi MV, Kaukoranta PK, Kiviluoma KT, Ylitalo KV, Peuhkurinen KJ| title=Ischemic preconditioning does not improve myocardial preservation during off-pump multivessel coronary operation. | journal=Ann Thorac Surg | year= 2003 | volume= 75 | issue= 4 | pages= 1246-52; discussion 1252-3 | pmid=12683571 | doi= | pmc= | url= }} </ref><ref name="pmid18783958">{{cite journal| author=Walsh SR, Tang TY, Kullar P, Jenkins DP, Dutka DP, Gaunt ME| title=Ischaemic preconditioning during cardiac surgery: systematic review and meta-analysis of perioperative outcomes in randomised clinical trials. | journal=Eur J Cardiothorac Surg | year= 2008 | volume= 34 | issue= 5 | pages= 985-94 | pmid=18783958 | doi=10.1016/j.ejcts.2008.07.062 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18783958  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''


'''3.''' Remote ischemic preconditioning strategies using peripheral-extremity occlusion/reperfusion might be considered to attenuate the adverse consequences of myocardial reperfusion injury. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''
'''3.''' Remote ischemic preconditioning strategies using peripheral-extremity occlusion/reperfusion might be considered to attenuate the adverse consequences of myocardial reperfusion injury.<ref name="pmid17707752">{{cite journal| author=Hausenloy DJ, Mwamure PK, Venugopal V, Harris J, Barnard M, Grundy E et al.| title=Effect of remote ischaemic preconditioning on myocardial injury in patients undergoing coronary artery bypass graft surgery: a randomised controlled trial. | journal=Lancet | year= 2007 | volume= 370 | issue= 9587 | pages= 575-9 | pmid=17707752 | doi=10.1016/S0140-6736(07)61296-3 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17707752  }} </ref><ref name="pmid20837926">{{cite journal| author=Rahman IA, Mascaro JG, Steeds RP, Frenneaux MP, Nightingale P, Gosling P et al.| title=Remote ischemic preconditioning in human coronary artery bypass surgery: from promise to disappointment? | journal=Circulation | year= 2010 | volume= 122 | issue= 11 Suppl | pages= S53-9 | pmid=20837926 | doi=10.1161/CIRCULATIONAHA.109.926667 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20837926  }} </ref><ref name="pmid19508973">{{cite journal| author=Venugopal V, Hausenloy DJ, Ludman A, Di Salvo C, Kolvekar S, Yap J et al.| title=Remote ischaemic preconditioning reduces myocardial injury in patients undergoing cardiac surgery with cold-blood cardioplegia: a randomised controlled trial. | journal=Heart | year= 2009 | volume= 95 | issue= 19 | pages= 1567-71 | pmid=19508973 | doi=10.1136/hrt.2008.155770 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19508973  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''


'''4.''' The effectiveness of postconditioning strategies to attenuate the adverse consequences of myocardial reperfusion injury is uncertain. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''}}
'''4.''' The effectiveness of postconditioning strategies to attenuate the adverse consequences of myocardial [[reperfusion injury]] is uncertain.<ref name="pmid18078762">{{cite journal| author=Luo W, Li B, Chen R, Huang R, Lin G| title=Effect of ischemic postconditioning in adult valve replacement. | journal=Eur J Cardiothorac Surg | year= 2008 | volume= 33 | issue= 2 | pages= 203-8 | pmid=18078762 | doi=10.1016/j.ejcts.2007.11.010 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18078762  }} </ref><ref name="pmid20448097">{{cite journal| author=Ovize M, Baxter GF, Di Lisa F, Ferdinandy P, Garcia-Dorado D, Hausenloy DJ et al.| title=Postconditioning and protection from reperfusion injury: where do we stand? Position paper from the Working Group of Cellular Biology of the Heart of the European Society of Cardiology. | journal=Cardiovasc Res | year= 2010 | volume= 87 | issue= 3 | pages= 406-23 | pmid=20448097 | doi=10.1093/cvr/cvq129 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20448097  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''}}


==Guidelines Resources==
==Guidelines Resources==

Revision as of 16:24, 2 December 2011

Coronary Artery Bypass Surgery Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]

ACCF/AHA Guidelines for Preconditioning/Management of Myocardial Ischemia[1]

Class I

1. Management targeted at optimizing the determinants of coronary arterial perfusion (eg, heart rate, diastolic or mean arterial pressure, and right ventricular or LV end-diastolic pressure) is recommended to reduce the risk of perioperative myocardial ischemia and infarction.[2][3][4][5][6] (Level of Evidence: B)

Class IIa

1. Volatile-based anesthesia can be useful in reducing the risk of perioperative myocardial ischemia and infarction.[7][8][9][10] (Level of Evidence: A)

Class IIb

1. The effectiveness of prophylactic pharmacological therapies or controlled reperfusion strategies aimed at inducing preconditioning or attenuating the adverse consequences of myocardial reperfusion injury or surgically induced systemic inflammation is uncertain.[11][12][13][14][15][16][17][18] (Level of Evidence: A)

2. Mechanical preconditioning might be considered to reduce the risk of perioperative myocardial ischemia and infarction in patients undergoing off-pump CABG.[19][20][21] (Level of Evidence: B)

3. Remote ischemic preconditioning strategies using peripheral-extremity occlusion/reperfusion might be considered to attenuate the adverse consequences of myocardial reperfusion injury.[22][23][24] (Level of Evidence: B)

4. The effectiveness of postconditioning strategies to attenuate the adverse consequences of myocardial reperfusion injury is uncertain.[25][26] (Level of Evidence: C)

Guidelines Resources

  • 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery : A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[1]

References

  1. 1.0 1.1 Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG; et al. (2011). "2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. doi:10.1161/CIR.0b013e31823c074e. PMID 22064599.
  2. Slogoff S, Keats AS (1985). "Does perioperative myocardial ischemia lead to postoperative myocardial infarction?". Anesthesiology. 62 (2): 107–14. PMID 3970360.
  3. Dyub AM, Whitlock RP, Abouzahr LL, Cinà CS (2008). "Preoperative intra-aortic balloon pump in patients undergoing coronary bypass surgery: a systematic review and meta-analysis". J Card Surg. 23 (1): 79–86. doi:10.1111/j.1540-8191.2007.00499.x. PMID 18290898.
  4. Heusch G (2008). "Heart rate in the pathophysiology of coronary blood flow and myocardial ischaemia: benefit from selective bradycardic agents". Br J Pharmacol. 153 (8): 1589–601. doi:10.1038/sj.bjp.0707673. PMC 2438254. PMID 18223669.
  5. Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF; et al. (2002). "ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines)". J Am Coll Cardiol. 40 (8): 1531–40. PMID 12392846.
  6. Lavana JD, Fraser JF, Smith SE, Drake L, Tesar P, Mullany DV (2010). "Influence of timing of intraaortic balloon placement in cardiac surgical patients". J Thorac Cardiovasc Surg. 140 (1): 80–5. doi:10.1016/j.jtcvs.2009.09.033. PMID 19909993.
  7. Landoni G, Biondi-Zoccai GG, Zangrillo A, Bignami E, D'Avolio S, Marchetti C; et al. (2007). "Desflurane and sevoflurane in cardiac surgery: a meta-analysis of randomized clinical trials". J Cardiothorac Vasc Anesth. 21 (4): 502–11. doi:10.1053/j.jvca.2007.02.013. PMID 17678775.
  8. Lucchinetti E, Hofer C, Bestmann L, Hersberger M, Feng J, Zhu M; et al. (2007). "Gene regulatory control of myocardial energy metabolism predicts postoperative cardiac function in patients undergoing off-pump coronary artery bypass graft surgery: inhalational versus intravenous anesthetics". Anesthesiology. 106 (3): 444–57. PMID 17325502.
  9. Yao YT, Li LH (2009). "Sevoflurane versus propofol for myocardial protection in patients undergoing coronary artery bypass grafting surgery: a meta-analysis of randomized controlled trials". Chin Med Sci J. 24 (3): 133–41. PMID 19848312.
  10. Yu CH, Beattie WS (2006). "The effects of volatile anesthetics on cardiac ischemic complications and mortality in CABG: a meta-analysis". Can J Anaesth. 53 (9): 906–18. doi:10.1007/BF03022834. PMID 16960269.
  11. Rabi D, Clement F, McAlister F, Majumdar S, Sauve R, Johnson J; et al. (2010). "Effect of perioperative glucose-insulin-potassium infusions on mortality and atrial fibrillation after coronary artery bypass grafting: a systematic review and meta-analysis". Can J Cardiol. 26 (6): 178–84. PMC 2903988. PMID 20548978.
  12. Buckberg GD (2010). "Controlled reperfusion after ischemia may be the unifying recovery denominator". J Thorac Cardiovasc Surg. 140 (1): 12–8, 18.e1–2. doi:10.1016/j.jtcvs.2010.02.014. PMID 20416890.
  13. MEND-CABG II Investigators. Alexander JH, Emery RW, Carrier M, Ellis SJ, Mehta RH; et al. (2008). "Efficacy and safety of pyridoxal 5'-phosphate (MC-1) in high-risk patients undergoing coronary artery bypass graft surgery: the MEND-CABG II randomized clinical trial". JAMA. 299 (15): 1777–87. doi:10.1001/jama.299.15.joc80027. PMID 18381567.
  14. Mangano DT (1997). "Effects of acadesine on myocardial infarction, stroke, and death following surgery. A meta-analysis of the 5 international randomized trials. The Multicenter Study of Perioperative Ischemia (McSPI) Research Group". JAMA. 277 (4): 325–32. PMID 9002496.
  15. Mangano DT, Miao Y, Tudor IC, Dietzel C, Investigators of the Multicenter Study of Perioperative Ischemia (McSPI) Research Group. Ischemia Research and Education Foundation (IREF) (2006). "Post-reperfusion myocardial infarction: long-term survival improvement using adenosine regulation with acadesine". J Am Coll Cardiol. 48 (1): 206–14. doi:10.1016/j.jacc.2006.04.044. PMID 16814669.
  16. Shernan SK, Fitch JC, Nussmeier NA, Chen JC, Rollins SA, Mojcik CF; et al. (2004). "Impact of pexelizumab, an anti-C5 complement antibody, on total mortality and adverse cardiovascular outcomes in cardiac surgical patients undergoing cardiopulmonary bypass". Ann Thorac Surg. 77 (3): 942–9, discussion 949-50. doi:10.1016/j.athoracsur.2003.08.054. PMID 14992903.
  17. Smith PK, Shernan SK, Chen JC, Carrier M, Verrier ED, Adams PX; et al. (2011). "Effects of C5 complement inhibitor pexelizumab on outcome in high-risk coronary artery bypass grafting: combined results from the PRIMO-CABG I and II trials". J Thorac Cardiovasc Surg. 142 (1): 89–98. doi:10.1016/j.jtcvs.2010.08.035. PMID 20880552.
  18. Testa L, Van Gaal WJ, Bhindi R, Biondi-Zoccai GG, Abbate A, Agostoni P; et al. (2008). "Pexelizumab in ischemic heart disease: a systematic review and meta-analysis on 15,196 patients". J Thorac Cardiovasc Surg. 136 (4): 884–93. doi:10.1016/j.jtcvs.2007.12.062. PMID 18954626.
  19. Laurikka J, Wu ZK, Iisalo P, Kaukinen L, Honkonen EL, Kaukinen S; et al. (2002). "Regional ischemic preconditioning enhances myocardial performance in off-pump coronary artery bypass grafting". Chest. 121 (4): 1183–9. PMID 11948051.
  20. Penttilä HJ, Lepojärvi MV, Kaukoranta PK, Kiviluoma KT, Ylitalo KV, Peuhkurinen KJ (2003). "Ischemic preconditioning does not improve myocardial preservation during off-pump multivessel coronary operation". Ann Thorac Surg. 75 (4): 1246–52, discussion 1252-3. PMID 12683571.
  21. Walsh SR, Tang TY, Kullar P, Jenkins DP, Dutka DP, Gaunt ME (2008). "Ischaemic preconditioning during cardiac surgery: systematic review and meta-analysis of perioperative outcomes in randomised clinical trials". Eur J Cardiothorac Surg. 34 (5): 985–94. doi:10.1016/j.ejcts.2008.07.062. PMID 18783958.
  22. Hausenloy DJ, Mwamure PK, Venugopal V, Harris J, Barnard M, Grundy E; et al. (2007). "Effect of remote ischaemic preconditioning on myocardial injury in patients undergoing coronary artery bypass graft surgery: a randomised controlled trial". Lancet. 370 (9587): 575–9. doi:10.1016/S0140-6736(07)61296-3. PMID 17707752.
  23. Rahman IA, Mascaro JG, Steeds RP, Frenneaux MP, Nightingale P, Gosling P; et al. (2010). "Remote ischemic preconditioning in human coronary artery bypass surgery: from promise to disappointment?". Circulation. 122 (11 Suppl): S53–9. doi:10.1161/CIRCULATIONAHA.109.926667. PMID 20837926.
  24. Venugopal V, Hausenloy DJ, Ludman A, Di Salvo C, Kolvekar S, Yap J; et al. (2009). "Remote ischaemic preconditioning reduces myocardial injury in patients undergoing cardiac surgery with cold-blood cardioplegia: a randomised controlled trial". Heart. 95 (19): 1567–71. doi:10.1136/hrt.2008.155770. PMID 19508973.
  25. Luo W, Li B, Chen R, Huang R, Lin G (2008). "Effect of ischemic postconditioning in adult valve replacement". Eur J Cardiothorac Surg. 33 (2): 203–8. doi:10.1016/j.ejcts.2007.11.010. PMID 18078762.
  26. Ovize M, Baxter GF, Di Lisa F, Ferdinandy P, Garcia-Dorado D, Hausenloy DJ; et al. (2010). "Postconditioning and protection from reperfusion injury: where do we stand? Position paper from the Working Group of Cellular Biology of the Heart of the European Society of Cardiology". Cardiovasc Res. 87 (3): 406–23. doi:10.1093/cvr/cvq129. PMID 20448097.

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