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Review
. 2020 Dec;131(6):1751-1764.
doi: 10.1213/ANE.0000000000005234.

Perioperative Cardioprotection: Clinical Implications

Sebastian Roth  1 , Carolin Torregroza  1   2 , Ragnar Huhn  1 , Markus W Hollmann  2 , Benedikt Preckel  2
Affiliations
Review

Perioperative Cardioprotection: Clinical Implications

Sebastian Roth et al. Anesth Analg. 2020 Dec.

Abstract

Perioperative cardioprotection aims to minimize the consequences of myocardial ischemia-reperfusion injury. In isolated tissue and animal experiments, several treatments have been identified providing cardioprotection. Some of these strategies have been confirmed in clinical proof-of-concept studies. However, the final translation of cardioprotective strategies to really improve clinical outcome has been disappointing: large randomized controlled clinical trials mostly revealed inconclusive, neutral, or negative results. This review provides an overview of the currently available evidence regarding clinical implications of perioperative cardioprotective therapies from an anesthesiological perspective, highlighting nonpharmacological as well as pharmacological strategies. We discuss reasons why translation of promising experimental results into clinical practice and outcome improvement is hampered by potential confounders and suggest future perspectives to overcome these limitations.

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References

    1. Ponikowski P, Voors AA, Anker SD, et al.; ESC Scientific Document Group. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37:2129–2200.
    1. Head SJ, Howell NJ, Osnabrugge RL, et al. The European Association for Cardio-Thoracic Surgery (EACTS) database: an introduction. Eur J Cardiothorac Surg. 2013;44:e175–e180.
    1. Puelacher C, Lurati Buse G, Seeberger D, et al.; BASEL-PMI Investigators. Perioperative myocardial injury after noncardiac surgery: incidence, mortality, and characterization. Circulation. 2018;137:1221–1232.
    1. D’Agostino RS, Jacobs JP, Badhwar V, et al. The society of thoracic surgeons adult cardiac surgery database: 2018 update on outcomes and quality. Ann Thorac Surg. 2018;105:15–23.
    1. Hillis LD, Smith PK, Bittl JA, et al. 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. 2011;124:652–735.

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