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Impact of the American College of Cardiology/American Heart Association guidelines for interpretability of continuous electrocardiography on the association of silent ischemia with troponin release after major noncardiac surgery

Lurati Buse, Giovanna A. and Seeberger, Manfred D. and Schumann, Regina M. and Bürgler, David and Schwab, Hildebrand S. and Bolliger, Daniel and Filipovic, Miodrag. (2009) Impact of the American College of Cardiology/American Heart Association guidelines for interpretability of continuous electrocardiography on the association of silent ischemia with troponin release after major noncardiac surgery. Journal of electrocardiology : an international publication for the study of the electrical activities of the heart, Vol. 42 , S. 455-461.e1.

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Official URL: http://edoc.unibas.ch/dok/A6002913

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Abstract

INTRODUCTION: Preexisting electrocardiographic abnormalities may limit accuracy of continuous electrocardiography (cECG) for ischemia determination. The American College of Cardiology/American Heart Association published criteria for the exclusion of unsuitable cECG curves from ST-segment interpretation. These criteria consider medication and 12-lead ECG findings (medication- and 12-lead ECG-based criteria) and cECG lead characteristics (cECG-based criteria). METHODS: We recorded cECG in 300 patients undergoing major noncardiac surgery. We determined postoperative troponin and 12-month outcome. We compared the associations of cECG-detected ischemia with troponin and 12-month outcome with and without adherence to the criteria. RESULTS: Adherence to the medication- and 12-lead ECG-based criteria enhanced the association between troponin and perioperative ischemia in CM5 (odds ratio, 3.74; 95% confidence interval, 1.88-7.44) and 7.03 (2.67-18.49), respectively; P = .049). Similarly, the association between ischemia in CM5 and 12-month outcome tended to increase (P = .081). CONCLUSIONS: Applying the guideline criteria for the interpretation of cECG enhanced cECG diagnostic value in surgical patients.
Faculties and Departments:03 Faculty of Medicine > Bereich Querschnittsfächer (Klinik) > Anästhesiologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Querschnittsfächer (Klinik) > Anästhesiologie
UniBasel Contributors:Seeberger-Stucky, Manfred and Filipovic, Miodrag
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Churchill Livingstone
ISSN:0022-0736
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:01 Feb 2013 08:46
Deposited On:01 Feb 2013 08:42

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