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«Клиническая физиология кровообращения»

Главный редактор

Лео Антонович Бокерия, доктор медицинских наук, профессор, академик РАН и РАМН, президент ФГБУ «НМИЦ ССХ им. А.Н. Бакулева» МЗ РФ


Прогнозирование риска повреждения миокарда при выполнении операции каротидной эндартерэктомии

Авторы: Вачев А.Н., Терешина О.В., Дмитриев О.В., Белкин Ю.С.

Организация:
ФГБОУ ВО «Самарский государственный медицинский университет» Минздрава России, Самара, Российская Федерация

Для корреспонденции: Сведения доступны для зарегистрированных пользователей.

Раздел: Обзоры

DOI: https://doi.org/10.24022/1814-6910-2021-18-3-185-192

УДК: 616.127:616.133]-089

Библиографическая ссылка: Клиническая физиология кровообращения. 2021; 3 (18): 181-256

Цитировать как: Вачев А.Н., Терешина О.В., Дмитриев О.В., Белкин Ю.С. . Прогнозирование риска повреждения миокарда при выполнении операции каротидной эндартерэктомии. Клиническая физиология кровообращения. 2021; 3 (18): 181-256. DOI: 10.24022/1814-6910-2021-18-3-185-192

Ключевые слова: периоперационный период, каротидная эндартерэктомия, ишемия миокарда, оценка кардиального риска

Поступила / Принята к печати:  11.05.2021 / 08.06.2021

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Аннотация

В актуальных рекомендациях по предоперационной оценке кардиального риска при выполнении некардиохирургических операций предлагается проводить стратификацию риска с помощью пересмотренного индекса кардиального риска (Revised Cardiac Risk Index) и калькулятора инфаркта миокарда и остановки сердца (Myocardial Infarction and Cardiac Arrest Calculator) Национальной программы повышения качества хирургической помощи (National Surgical Quality Improvement Program). Однако уже имеются данные, показывающие, что корректно оценить посредством этих шкал предоперационный риск при сосудистых оперативных вмешательствах в целом и при каротидной эндартерэктомии в частности не всегда возможно. Целью данного обзорного исследования является описание и анализ имеющихся на сегодняшний день клинических моделей для периоперационной оценки кардиального риска у пациентов перед операцией каротидной эндартерэктомии.

Литература

  1. Devereaux P.J., Sessler D.I. Cardiac complications in patients undergoing major noncardiac surgery. N. Engl. J. Med. 2015; 373 (23): 2258–69. DOI: 10.1056/NEJMra1502824
  2. Aboyans V., Ricco J.B., Bartelink M.E.L., Björck M., Brodmann M., Cohnert T. et al. ESC Scientific Document Group. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries. Endorsed by: the European Stroke Organization (ESO). The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur. Heart J. 2018; 39 (9): 763–816. DOI: 10.1093/eurheartj/ehx095
  3. Illuminati G., Schneider F., Greco C., Mangieri E., Schiariti M., Tanzilli G. et al. Long-term results of a randomized controlled trial analyzing the role of systematic pre-operative coronary angiography before elective carotid endarterectomy in patients with asymptomatic coronary artery disease. Eur. J. Vasc. Endovasc. Surg. 2015; 49 (4): 366–74. DOI: 10.1016/j.ejvs.2014.12.0304
  4. Devereaux P.J., Biccard B.M., Sigamani A., Xavier D., Chan M.T.V., Srinathan S.K. et al. Association of postoperative high-sensitivity troponin levels with myocardial injury and 30-day mortality among patients undergoing noncardiac surgery. JAMA. 2017; 317 (16): 1642–51. DOI: 10.1001/jama.2017.4360
  5. Górka J., Polok K., Fronczek J., Górka K., Kózka M., Iwaszczuk P. et al. Myocardial injury is more common than deep venous thrombosis after vascular surgery and is associated with a high one year mortality risk. Eur. J. Vasc. Endovasc. Surg. 2018; 56 (2): 264–70. DOI: 10.1016/j.ejvs.2018.02.005
  6. Biccard B. Proposed research plan for the derivation of a new Cardiac Risk Index. Anesth. Analg. 2015; 120 (3): 543–53. DOI: 10.1213/ANE.0000000000000598
  7. Brown J.C., Samaha E., Rao S., Helwani M.A., Duma A., Brown F. et al. High-sensitivity cardiac Troponin T improves the diagnosis of perioperative MI. Anesth. Analg. 2017; 125 (5): 1455–62. DOI: 10.1213/ANE. 0000000000002240
  8. Twerenbold R., Jaeger C., Rubini Gimenez M., Wildi K., Reichlin T., Nestelberger T. et al. Impact of high-sensitivity cardiac troponin on use of coronary angiography, cardiac stress testing, and time to discharge in suspected acute myocardial infarction. Eur. Heart J. 2016; 37 (44): 3324–32. DOI: 10.1093/eurheartj/ehw232
  9. Devereaux P.J., Xavier D., Pogue J., Guyatt G., Sigamani A., Garutti I. et al. Characteristics and shortterm prognosis of perioperative myocardial infarction in patients undergoing noncardiac surgery: a cohort study. Ann. Intern. Med. 2011; 154 (8): 523–8. DOI: 10.7326/0003-4819-154-8-201104190-00003
  10. Ruetzler K., Khanna A.K., Sessler D.I. Myocardial injury after noncardiac surgery: preoperative, intraoperative, and postoperative aspects, implications, and directions. Anesth. Analg. 2020; 131 (1): 173–86. DOI: 10.1213/ANE.0000000000004567
  11. Fleisher L.A., Fleischmann K.E., Auerbach A.D., Barnason S.A., Beckman J.A., Bozkurt B. et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014; 130 (24): 2215–45. DOI: 10.1161/CIR.0000000000000105
  12. Kristensen S.D., Knuuti J., Saraste A., Anker S., Bøtker H.E., Hert S.D. et al. Authors/Task Force Members. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur. Heart J. 2014; 35 (35): 2383–431. DOI: 10.1093/eurheartj/ehu282
  13. Lee T.H., Marcantonio E.R., Mangione C.M., Thomas E.J., Polanczyk C.A., Cook E.F. et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999; 100 (10): 1043–9. DOI: 10.1161/01.cir.100.10.1043
  14. Gupta P.K., Gupta H., Sundaram A., Kaushik M., Fang X., Miller W.J. et al. Development and validation of a risk calculator for prediction of cardiac risk after surgery. Circulation. 2011; 124 (4): 381–7. DOI: 10.1161/CIRCULATIONAHA.110.015701
  15. Davis C., Tait G., Carroll J., Wijeysundera D.N., Beattie W.S. The Revised Cardiac Risk Index in the new millennium: a single-centre prospective cohort reevaluation of the original variables in 9,519 consecutive elective surgical patients. Can. J. Anaesth. 2013; 60 (9): 855–63. DOI: 10.1007/s12630-013-9988-5 16. Peterson B., Ghahramani M., Harris S., SuchniakMussari K., Bedi G., Bulathsinghala C. et al. Usefulness of the Myocardial Infarction and Cardiac Arrest Calculator as a discriminator of adverse cardiac events after elective hip and knee surgery. Am. J. Cardiol. 2016; 117 (12): 1992–5. DOI: 10.1016/j.amjcard.2016.03.050
  16. Juo Y.Y., Mantha A., Ebrahimi R., Ziaeian B., Benharash P. Incidence of myocardial infarction after highrisk vascular operations in adults. JAMA Surg. 2017; 152 (11): e173360. DOI: 10.1001/jamasurg.2017.3360
  17. Duncan D., Wijeysundera D.N. Preoperative cardiac evaluation and management of the patient undergoing major vascular surgery. Int. Anesthesiol. Clin. 2016; 54 (2): 1–32. DOI: 10.1097/AIA.0000000000000091
  18. Bertges D.J., Goodney P.P., Zhao Y., Schanzer A., Nolan B.W., Likosky D.S. et al. Vascular Study Group of New England. The Vascular Study Group of New England Cardiac Risk Index (VSG-CRI) predicts cardiac complications more accurately than the Revised Cardiac Risk Index in vascular surgery patients. J. Vasc. Surg. 2010; 52 (3): 674–83, 683.e1–683.e3. DOI: 10.1016/j.jvs.2010.03.031
  19. Landesberg G., Shatz V., Akopnik I., Wolf Y.G., Mayer M., Berlatzky Y. et al. Association of cardiac troponin, CK-MB, and postoperative myocardial ischemia with long-term survival after major vascular surgery. J. Am. Coll. Cardiol. 2003; 42 (9): 1547–54. DOI: 10.1016/j.jacc.2003.05.001
  20. Pasternack P.F., Grossi E.A., Baumann F.G., Riles T.S., Lamparello P.J., Giangola G. et al. The value of silent myocardial ischemia monitoring in the prediction of perioperative myocardial infarction in patients undergoing peripheral vascular surgery. J. Vasc. Surg. 1989; 10 (6): 617–25. DOI: 10.1067/mva.1989.15572
  21. Puelacher C., Lurati Buse G., Seeberger D., Sazgary L., Marbot S., Lampart A. et al. Perioperative myocardial injury after noncardiac surgery: incidence, mortality, and characterization. Circulation. 2018; 137 (12): 1221–32. DOI: 10.1161/CIRCULATIONAHA.117.030114
  22. Thygesen K., Alpert J.S., Jaffe A.S., Chaitman B.R., Bax J.J., Morrow D.A. et al.; Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth Universal Definition of Myocardial Infarction (2018). J. Am. Coll. Cardiol. 2018; 72 (18): 2231–64. DOI: 10.1016/j.jacc.2018.08.1038
  23. Kavsak P.A., Walsh M., Srinathan S., Thorlacius L., Buse G.L., Botto F. еt al. High sensitivity troponin T concentrations in patients undergoing noncardiac surgery: a prospective cohort study. Clin. Biochem. 2011; 44 (12): 1021–4. DOI: 10.1016/j.clinbiochem. 2011.05.017
  24. Blackshear J.L., Cutlip D.E., Roubin G.S., Hill M.D., Leimgruber P.P., Begg R.J. et al. CREST Investigators. Myocardial infarction after carotid stenting and endarterectomy: results from the carotid revascularization endarterectomy versus stenting trial. Circulation. 2011; 123 (22): 2571–8. DOI: 10.1161/CIRCULATIONAHA.110.008250
  25. Payne C.J., Bryce G.J., Gibson S.C., Kingsmore D.B. The Revised Cardiac Risk Index performs poorly in patients undergoing major vascular surgery: a prospective observational study. Eur. J. Anaesthesiol. 2013; 30 (11): 713–5. DOI: 10.1097/EJA.0b013e3283628d7c
  26. Bursi F., Babuin L., Barbieri A., Politi L., Zennaro M., Grimaldi T. et al. Vascular surgery patients: perioperative and long-term risk according to the ACC/AHA guidelines, the additive role of post-operative troponin elevation. Eur. Heart J. 2005; 26 (22): 2448–56. DOI: 10.1093/eurheartj/ehi430
  27. Ford M.K., Beattie W.S., Wijeysundera D.N. Systematic review: prediction of perioperative cardiac complications and mortality by the revised cardiac risk index. Ann. Intern. Med. 2010; 152 (1): 26–35. DOI: 10.7326/0003-4819-152-1-201001050-00007
  28. Parmar C.D., Torella F. Prediction of major adverse cardiac events in vascular surgery: are cardiac risk scores of any practical value? Vasc. Endovascular. Surg. 2010; 44 (1): 14–9. DOI: 10.1177/1538574409349320
  29. Wolters U., Wolf T., Stützer H., Schröder T. ASA classification and perioperative variables as predictors of postoperative outcome. Br. J. Anaesth. 1996; 77 (2): 217–22. DOI: 10.1093/bja/77.2.217
  30. Gupta P.K., Ramanan B., Mactaggart J.N., Sundaram A., Fang X., Gupta H. et al. Risk index for predicting perioperative stroke, myocardial infarction, or death risk in asymptomatic patients undergoing carotid endarterectomy. J. Vasc. Surg. 2013; 57 (2): 318–26. DOI: 10.1016/j.jvs.2012.08.116
  31. Calvillo-King L., Xuan L., Zhang S., Tuhrim S., Halm E.A. Predicting risk of perioperative death and stroke after carotid endarterectomy in asymptomatic patients: derivation and validation of a clinical risk score. Stroke. 2010; 41 (12): 2786–94. DOI: 10.1161/STROKEAHA.110.599019
  32. Galyfos G., Tsioufis C., Theodorou D., Katsaragakis S., Zografos G., Filis K. Cardiac troponin I after carotid endarterectomy in different cardiac risk patients. J. Stroke Cerebrovasc. Dis. 2015; 24 (3): 711–7. DOI: 10.1016/j.jstrokecerebrovasdis.2014.11.024
  33. Divya K.P., Sandeep N., Sarma S., Sylaja P.N. Risk of stroke and cardiac events in medically treated asymptomatic carotid stenosis. J. Stroke Cerebrovasc. Dis. 2015; 24 (9): 2149–53. DOI: 10.1016/j.jstrokecerebrovasdis. 2015.05.030
  34. Van Damme H., PiОrard L., Gillain D., Benoit T., Rigo P., Limet R. Cardiac risk assessment before vascular surgery: a prospective study comparing clinical evaluation, dobutamine stress echocardiography, and dobutamine Tc-99m sestamibi tomoscintigraphy. Cardiovasc. Surg. 1997; 5 (1): 54–64. DOI: 10.1016/s0967-2109(96)00089-0
  35. Galyfos G., Tsioufis C., Theodorou D., Katsaragakis S., Zografos G., Filis K. Predictive role of stress echocardiography before carotid endarterectomy in patients with coronary artery disease. Echocardiography. 2015; 32 (7): 1087–93. DOI: 10.1111/echo.12826
  36. Koshy A.N., Ha F.J., Gow P.J., Han H.C., AmirulIslam F.M., Lim H.S. et al. Computed tomographic coronary angiography in risk stratification prior to non-cardiac surgery: a systematic review and metaanalysis. Heart. 2019; 105 (17): 1335–42. DOI: 10.1136/heartjnl-2018-314649
  37. Krievins D., Zellans E., Latkovskis G., Jegere S., Kumsars I., Kaufmanis K. et al. Diagnosis and management of silent coronary ischemia in patients undergoing carotid endarterectomy. J. Vasc. Surg. 2021; 73 (2): 533–41. DOI: 10.1016/j.jvs.2020.06.045
  38. Landesberg G., Mosseri M., Shatz V., Akopnik I., Bocher M., Mayer M. et al. Cardiac troponin after major vascular surgery: the role of perioperative ischemia, preoperative thallium scanning, and coronary revascularization. J. Am. Coll. Cardiol. 2004; 44 (3): 569–75. DOI: 10.1016/j.jacc.2004.03.073
  39. Zethelius B., Berglund L., Sundström J., Ingelsson E., Basu S., Larsson A. et al. Use of multiple biomarkers to improve the prediction of death from cardiovascular causes. N. Engl. J. Med. 2008; 358 (20): 2107–16. DOI: 10.1056/NEJMoa0707064
  40. Schiefermueller J., Myerson S., Handa A.I. Preoperative assessment and perioperative management of cardiovascular risk. Angiology. 2013; 64 (2): 146–50. DOI: 10.1177/0003319712440874
  41. Galyfos G., Tsioufis C., Theodorou D., Katsaragakis S., Zografos G., Filis K. Cardiac troponin I after carotid endarterectomy in different cardiac risk patients. J. Stroke Cerebrovasc. Dis. 2015; 24 (3): 711–7. DOI: 10.1016/j.jstrokecerebrovasdis.2014.11.024
  42. Devereaux P.J., Szczeklik W. Myocardial injury after non-cardiac surgery: diagnosis and management. Eur. Heart J. 2020; 41 (32): 3083–91. DOI: 10.1093/eurheartj/ehz301

Об авторах

  • Вачев Алексей Николаевич, д-р мед. наук, профессор, заведующий кафедрой факультетской хирургии; ORCID
  • Терешина Ольга Владимировна, канд. мед. наук, доцент, заведующая отделением функциональной диагностики; ORCID
  • Дмитриев Олег Владимирович, д-р мед. наук, доцент кафедры факультетской хирургии, заведующий отделением сердечно-сосудистой хирургии; ORCID
  • Белкин Юрий Сергеевич, студент 6-го курса; ORCID

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