The management of perioperative myocardial damage is focused on two issues: coronary plaque stabilization to reduce acute coronary syndromes and the subsequent supply ischemia (type 1 MI) that occurs when a coronary plaque ruptures; and limiting surgical stress, which is the cause of the sustained myocardial oxygen supply–demand imbalance (type 2 MI) [1]. Prophylactic pre-operative coronary revascularization in patients scheduled for non-cardiac surgery has failed to show any benefit [2] and [3]. In contrast, the most recent guidelines recommended the use of β-blockers in patients having high-risk surgery [4]. On the other hand, results of some other clinical trials do not support the use of perioperative β-blockers for the high risk of bradycardia and hypotension, stroke and death [5] and [6]. Ivabradine, specific inhibitor of the If current in sinoatrial node myocytes, reduces heart rate independently of sympathetic activation, and has demonstrated a reduction in the risk of coronary events in patients with elevated heart rate (≥ 70 bpm) or angina at baseline [7] and [8]. The objective of the current study was to determine if ivabradine would be equally effective to β-blockers in reducing cardiovascular risk in patients undergoing major vascular surgery in whom beta-blockers were contraindicate or unsafe.

The role of ivabradine in the incidence of perioperative coronary complications in patients undergoing vascular surgery / Lo Sapio P;Gensini GF;Bevilacqua S;Chiti E;Paperetti L;Pratesi C;Romano SM. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 0167-5273. - STAMPA. - 168:(2013), pp. 4352-4353. [10.1016/j.ijcard.2013.05.072]

The role of ivabradine in the incidence of perioperative coronary complications in patients undergoing vascular surgery.

GENSINI, GIAN FRANCO;PRATESI, CARLO;ROMANO, SALVATORE
2013

Abstract

The management of perioperative myocardial damage is focused on two issues: coronary plaque stabilization to reduce acute coronary syndromes and the subsequent supply ischemia (type 1 MI) that occurs when a coronary plaque ruptures; and limiting surgical stress, which is the cause of the sustained myocardial oxygen supply–demand imbalance (type 2 MI) [1]. Prophylactic pre-operative coronary revascularization in patients scheduled for non-cardiac surgery has failed to show any benefit [2] and [3]. In contrast, the most recent guidelines recommended the use of β-blockers in patients having high-risk surgery [4]. On the other hand, results of some other clinical trials do not support the use of perioperative β-blockers for the high risk of bradycardia and hypotension, stroke and death [5] and [6]. Ivabradine, specific inhibitor of the If current in sinoatrial node myocytes, reduces heart rate independently of sympathetic activation, and has demonstrated a reduction in the risk of coronary events in patients with elevated heart rate (≥ 70 bpm) or angina at baseline [7] and [8]. The objective of the current study was to determine if ivabradine would be equally effective to β-blockers in reducing cardiovascular risk in patients undergoing major vascular surgery in whom beta-blockers were contraindicate or unsafe.
2013
168
4352
4353
Lo Sapio P;Gensini GF;Bevilacqua S;Chiti E;Paperetti L;Pratesi C;Romano SM
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/806873
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