Preoperative coronary angiography in vascular surgery patients with asymptomatic elevated high-sensitivity troponin T: a case series

Br J Anaesth. 2019 Nov;123(5):565-569. doi: 10.1016/j.bja.2019.08.013. Epub 2019 Sep 21.

Abstract

This case series presents 10 patients undergoing vascular surgery with asymptomatic elevated high-sensitivity troponin T concentrations, measured at outpatient clinic before surgery. Patients were included in the RAVE (Rotterdam Antiplatelet therapy in Vascular patiEnts) pilot study. All included patients underwent coronary angiography before surgery to identify significant obstructive coronary artery disease. We identified five out of 10 patients with high-grade stenosis and high-risk angiographic features of left main and/or proximal left anterior descending coronary artery disease. The study was terminated prematurely before any subject reached the study endpoint of 1 yr follow-up. This case series provides more insight into the meaning of preoperative troponin elevation and coronary angiographic features in vascular surgery patients. TRIAL REGISTRY NUMBER: NL5803.

Keywords: coronary angiography; coronary artery disease; dual antiplatelet therapy; myocardial ischaemia; troponin T.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Coronary Angiography / methods*
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / surgery
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Pilot Projects
  • Preoperative Care / methods*
  • Risk Factors
  • Troponin T / blood*
  • Vascular Surgical Procedures*

Substances

  • Troponin T