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首页> 外文期刊>Progress in Artificial Intelligence >Anesthetic Agents and Cardiovascular Outcomes of Noncardiac Surgery after Coronary Stent Insertion
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Anesthetic Agents and Cardiovascular Outcomes of Noncardiac Surgery after Coronary Stent Insertion

机译：冠状动脉支架插入后非心动手术的麻醉剂和心血管结果

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Patients undergoing noncardiac surgery after coronary stent implantation are at an increased risk of thrombotic complications. Volatile anesthetics are reported to have organ-protective effects against ischemic injury. Propofol has an anti-inflammatory action that can mitigate ischemia-reperfusion injury. However, the association between anesthetic agents and the risk of major adverse cardiovascular and cerebral event (MACCE) has never been studied before. In the present study, a total of 1630 cases were reviewed. Four different propensity score matchings were performed to minimize selection bias (propofol-based total intravenous anesthesia (TIVA) vs. volatile anesthetics; TIVA vs. sevoflurane; TIVA vs. desflurane; and sevoflurane vs. desflurane). The incidence of MACCE in these four propensity score-matched cohorts was compared. As a sensitivity analysis, a multivariable logistic regression analysis was performed to identify independent predictors for MACCE during the postoperative 30 days both in total and matched cohorts (TIVA vs. volatile agent). MACCE occurred in 6.0% of the patients. Before matching, there was a significant difference in the incidence of MACCE between TIVA and sevoflurane groups (TIVA 5.1% vs. sevoflurane 8.2%, p = 0.006). After matching, there was no significant difference in the incidence of MACCE between the groups of any pairs (TIVA 6.5% vs. sevoflurane 7.7%; p = 0.507). The multivariable logistic regression analysis revealed no significant association of the volatile agent with MACCE (odds ratio 1.48, 95% confidence interval 0.92-2.37, p = 0.104). In conclusion, the choice of anesthetic agent for noncardiac surgery did not significantly affect the development of MACCE in patients with previous coronary stent implantation. However, further randomized trials are needed to confirm our results.
机译：在冠状动脉支架植入后接受非心脏手术的患者处于血栓形成并发症的风险增加。据报道，挥发性麻醉剂对缺血性损伤具有器官保护作用。异丙酚具有抗炎作用，可以减轻缺血再灌注损伤。然而，在以前从未研究过麻醉药物与主要不良心血管和脑事件（MACCE）的风险。在本研究中，共有1630例审查。进行了四种不同的倾销评分匹配以最小化选择偏压（基于异丙酚总静脉内麻醉（Tiva）与挥发性麻醉剂; Tiva与七氟醚; Tiva与Desfluane;和七氟醚与脱氟烷）。比较了这四个倾向分数匹配的群体中宏的发病率。作为敏感性分析，进行多变量的逻辑回归分析，以识别总共30天内的宏观的独立预测因子（Tiva对挥发剂）。宏观在6.0％的患者中发生。在匹配之前，Tiva和七氟醚基团之间的宏与七氟醚基团之间存在显着差异（Tiva 5.1％与七氟醚8.2％，p = 0.006）。在匹配后，任何对组之间的宏的发生率没有显着差异（Tiva 6.5％与七氟醚7.7％; p = 0.507）。多变量逻辑回归分析显示出挥发性药物没有显着的挥发性剂与宏（差距1.48,95％置信区间0.92-2.37，P = 0.104）。总之，非心动手术麻醉剂的选择并未显着影响冠状动脉植入患者癌症的发育。但是，需要进一步的随机试验来确认我们的结果。

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