The Extent of Myocardial Injury During Prolonged Targeted Temperature Management After Out-of-Hospital Cardiac Arrest Anders Morten Grejs, MD, Jakob.

Slides:

Advertisements

Similar presentations

Low-Dose Aspirin in Patients with Stable Cardiovascular Disease: A Meta-analysis Jeffrey S. Berger, MD, MS, David L. Brown, MD, Richard C. Becker, MD The.

Advertisements

The Epidemic of the 20th Century: Coronary Heart Disease

Impact of Co-morbidity on the Risk of First-Time Myocardial Infarction, Stroke, or Death After Single-Photon Emission Computed Tomography Myocardial Perfusion.

Influence of Diabetes Mellitus on Clinical Outcomes Following Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial.

The Extent of Myocardial Injury During Prolonged Targeted Temperature Management After Out-of-Hospital Cardiac Arrest Anders Morten Grejs, MD, Jakob.

Paul D. Stein, MD, Fadi Matta, MD, Mary J. Hughes, DO

Mortality Rate in Type 2 Myocardial Infarction: Observations from an Unselected Hospital Cohort Lotte Saaby, MD, Tina Svenstrup Poulsen, MD, PhD, Axel.

Classification of Myocardial Infarction: Frequency and Features of Type 2 Myocardial Infarction Lotte Saaby, MD, Tina Svenstrup Poulsen, MD, PhD, Susanne.

Incidence, Frequency, and Clinical Characteristics of Type 3 Myocardial Infarction in Clinical Practice Nikolaj Jangaard, MD, Laura Sarkisian, MD, Lotte.

Pneumothorax Recurrence Related to High-speed Lift

Comparison of Outcomes in Patients With Versus Without Diabetes Mellitus After Revascularization With Everolimus- and Sirolimus-Eluting Stents (from the.

Bleeding Toes in Diabetic Neuropathy

Sexuality The American Journal of Medicine

Ahmed Abuzaid, MD, Carly Fabrizio, DO, Kevin Felpel, MD, Haitham S

Long-term Trends in Short-term Outcomes in Acute Myocardial Infarction

‘Chest Pain Typicality’ in Suspected Acute Coronary Syndromes and the Impact of Clinical Experience Edward W. Carlton, MBChB, Martin Than, MBBS, Louise.

Richard V. Milani, MD, Carl J. Lavie, MD, Robert M

Bleeding Toes in Diabetic Neuropathy

Risk Factors for 30-Day Readmission in Adults with Sickle Cell Disease

Recurrent infarction causes the most deaths following myocardial infarction with left ventricular dysfunction Stein Ørn, MD, John G.F. Cleland, MD, Matti.

Significance of Elevated Cardiac Troponin T Levels in Critically Ill Patients with Acute Respiratory Disease Vlad C. Vasile, MD, PhD, High-Seng Chai,

Tim McAlindon, MD, MPH, Margaret Formica, MSPH, Christopher H

Matthew I. Worthley, MBBS, PhD, FRACP, Fiona M

Association of cardiac biomarkers with acute kidney injury after cardiac surgery: A multicenter cohort study Emilie P. Belley-Côté, MD, Chirag R. Parikh,

Early Diagnosis of Myocardial Infarction Using Absolute and Relative Changes in Cardiac Troponin Concentrations Affan Irfan, MD, Tobias Reichlin, MD,

Wandering Acute Myocardial Infarction

Schizophrenia for Primary Care Providers: How to Contribute to the Care of a Vulnerable Patient Population Mark Viron, MD, Travis Baggett, MD, MPH, Michele.

Transient cardiac dysfunction in acute carbon monoxide poisoning

Epidemiology of Myelodysplastic Syndromes

Use of Targeted Temperature Management After Out-of-hospital Cardiac Arrest: A Meta- Analysis of Randomized Controlled Trials Ahmed Mahmoud, MD, Islam.

Jin H. Han, MD, Abhinav Chandra, MD, Jyotsna Mulgund, MS, Matthew T

Laura Sarkisian, MD, Lotte Saaby, MD, PhD, Tina S

Reactive Hemophagocytic Syndrome in Adults: A Retrospective Analysis of 162 Patients Sébastien Rivière, MD, Lionel Galicier, MD, Paul Coppo, MD, PhD,

The Effect of a Statewide Smoking Ordinance on Acute Myocardial Infarction Rates Paul Basel, BS, Becki Bucher Bartelson, PhD, Marie Claire Le Lait, MS,

The Epidemic of the 20th Century: Coronary Heart Disease

Carotid Sinus Massage in Patients with Suspected Acute Myocardial Infarction, Tachycardia, and Left Bundle Branch Block Teddy Weiss, MD, Yair Elitzur,

Age and Gender Differences in Quality of Care and Outcomes for Patients with ST- segment Elevation Myocardial Infarction Sripal Bangalore, MD, MHA, Gregg.

Myocardial injury in coronary artery bypass grafting: On-pump versus off-pump comparison by measuring high-sensitivity C-reactive protein, cardiac troponin.

Risk Stratification in Non-ST-segment Elevation Acute Coronary Syndromes: Troponin Alone Is not Enough Philippe Gabriel Steg, Gordon FitzGerald, Keith.

Incidence, Frequency, and Clinical Characteristics of Type 3 Myocardial Infarction in Clinical Practice Nikolaj Jangaard, MD, Laura Sarkisian, MD, Lotte.

Classification of Myocardial Infarction: Frequency and Features of Type 2 Myocardial Infarction Lotte Saaby, MD, Tina Svenstrup Poulsen, MD, PhD, Susanne.

The Natural Course of Microalbuminuria among African Americans with Type 2 Diabetes: A 3-Year Study Mohamed G. Atta, MD, MPH, Kesha Baptiste-Roberts,

Type 1 and 2 Myocardial Infarction and Myocardial Injury: Clinical Transition to High- Sensitivity Cardiac Troponin I Yader Sandoval, MD, Stephen W. Smith,

Cold blood cardioplegia reduces the increase in cardiac enzyme levels compared with cold crystalloid cardioplegia in patients undergoing aortic valve.

The Reply The American Journal of Medicine

Yader Sandoval, MD, Stephen W. Smith, MD, Sara A

Seizure with Acute Pulmonary Infiltrates

Usefulness of CHADS2 and CHA2DS2-VASc Scores in the Prediction of New-Onset Atrial Fibrillation: A Population-Based Study Walid Saliba, MD, MPH, Naomi.

Jennifer Tjia, MD, MSCE, Jeroan Allison, MD, Jane S

Elevated High-Density Lipoprotein Cholesterol Is Associated with Hyponatremia in Hypertensive Patients Ariel Israel, MD, PhD, Ehud Grossman, MD The.

Mortality Rate in Type 2 Myocardial Infarction: Observations from an Unselected Hospital Cohort Lotte Saaby, MD, Tina Svenstrup Poulsen, MD, PhD, Axel.

Shannon M. Dunlay, MD, MS, Quinn R. Pack, MD, Randal J

Ultra-Sensitive Copeptin and Cardiac Troponin in Diagnosing Non-ST-Segment Elevation Acute Coronary Syndromes—The COPACS Study Fabrizio Ricci, MD, Rosa.

Opioid Use, Misuse, and Abuse in Patients Labeled as Fibromyalgia

To Reduce Stroke with PFO Closure, Respect the Shunt

Ahmed Abuzaid, MD, Carly Fabrizio, DO, Kevin Felpel, MD, Haitham S

John-Michael Gamble, BScPharm, MSc, Dean T. Eurich, PhD, Thomas J

Eagle's Syndrome The American Journal of Medicine

Purple Urinary Bag Syndrome

A Post-cure Complication

Carl van Walraven, MD, MSc, Alan J. Forster, MD, MSc

Plasma Lactescence in Acute Pancreatitis

Acute Reperfusion Therapy in ST-Elevation Myocardial Infarction from

E. -H. Lee, H. -M. Lee, C. -H. Chung, J. -H. Chin, D. -K. Choi, H. -J

Laszlo Littmann, MD, PhD, Michael H. Monroe, MD

Tombstone ST Elevations: … Not Necessarily a Harbinger of Doom!

Matthew W. Martinez, MD, Keith G. Rasmussen, MD, Paul S

Toward a More Responsible News Media

Preoperative Thienopyridine Use and Outcomes after Surgery: A Systematic Review Anita G. Au, MD, Sumit R. Majumdar, MD MPH, Finlay A. McAlister, MD MSc

Secular trends in cardiovascular disease mortality, incidence, and case fatality rates in adults in the United States Ahmet Ergin, MD, PhD, MPH, Paul.

Presentation transcript:

The Extent of Myocardial Injury During Prolonged Targeted Temperature Management After Out-of-Hospital Cardiac Arrest Anders Morten Grejs, MD, Jakob Gjedsted, MD, PhD, Kristian Thygesen, MD, DMSc, Jens Flensted Lassen, MD, PhD, Bodil Steen Rasmussen, MD, PhD, Anni Nørgaard Jeppesen, MD, Christophe Henri Valdemar Duez, MD, Eldar Søreide, MD, PhD, Hans Kirkegaard, MD, DMSc, PhD The American Journal of Medicine Volume 130, Issue 1, Pages 37-46 (January 2017) DOI: 10.1016/j.amjmed.2016.06.047 Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 1 Consort diagram showing the 375 patients screened for eligibility of whom 161 patients were included for analyses and of whom 63 patients had an acute myocardial infarction. The American Journal of Medicine 2017 130, 37-46DOI: (10.1016/j.amjmed.2016.06.047) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 2 Flowchart. The flowchart shows times on the x-axis and temperature on the y-axis with the intervals for biomarker sampling plotted. After 24 hours the 24-hour group is rewarmed at a rate of 0.5°C/h until 37°C (dotted line). After 48 hours the 48-hour group is rewarmed at a rate of 0.5°C/h until 37°C (dashed line). Dotted gray horizontal lines mark the target temperature zone between 32°C and 34°C. The American Journal of Medicine 2017 130, 37-46DOI: (10.1016/j.amjmed.2016.06.047) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 3 Cardiac biomarker profiles after out-of-hospital cardiac arrest. The curves of the total numbers of median values of high-sensitivity cardiac troponin T (hs-cTnT) and creatine kinase-myocardial band (CK-MB) in relation to the timing after out-of-hospital cardiac arrest. All hs-cTnT arrival values were elevated above the 99th percentile and the peak values of hs-cTnT occurred within the first 6 hours. The CK-MB arrival values were close to the upper reference limit and the peak values occurred at around 18 hours. The American Journal of Medicine 2017 130, 37-46DOI: (10.1016/j.amjmed.2016.06.047) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 4 Areas under the curve (AUC) of cardiac biomarkers, arranged according to the duration of targeted temperature management of 24 hours vs 48 hours after out-of-hospital cardiac arrest. The left part of the figure shows the high-sensitivity cardiac troponin T (hs-cTnT)AUC of all 161 out-of-hospital cardiac arrest patients, showing no significant difference between 24 hours vs 48 hours of targeted temperature management. Conversely, in the right part of the figure, creatine kinase-myocardial band (CK-MB)AUC of all the 161 out-of-hospital cardiac arrest patients shows that 48 hours is significantly higher than 24 hours of targeted temperature management. The American Journal of Medicine 2017 130, 37-46DOI: (10.1016/j.amjmed.2016.06.047) Copyright © 2016 Elsevier Inc. Terms and Conditions