| Exercise blood pressure response and perioperative complications after major vascular surgery. | |
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MedLine Citation:
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PMID: 21394025 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: Earlier studies have shown that hypertensive or hypotensive blood pressure (BP) response during a preoperative treadmill exercise test in patients with peripheral arterial disease is associated with a two-fold increased risk of cardiovascular events and mortality. However, it is unknown if these patients also experience an increased perioperative complication risk at major vascular surgery. METHODS: In total 665 consecutive patients with peripheral arterial disease underwent elective major vascular surgery (carotid endarterectomy, abdominal aorta repair, or lower extremity revascularization). Perioperative complications (infection, myocardial infarction, angina pectoris, cardiac arrhythmia, heart failure, cerebrovascular accident or spinal cord ischemia, dialyses, amputation, thrombectomy, reoperation or death) were defined as occurring within 30 days after surgery and were collected using medical records. Hypertensive BP response was defined as a difference between exercise systolic BP and resting systolic BP of more than 55 mmHg. Hypotensive BP response was defined as a drop in exercise systolic BP below resting systolic BP. RESULTS: Patients with a hypertensive BP response during a preoperative exercise test (n=66) showed a higher risk of early perioperative thrombectomy [hazard ratio (HR) 2.80 95% CI (1.24-6.33)] compared with patients with a normal BP response (n=582). Patients with a hypotensive BP response (n=18) showed an increased risk of perioperative myocardial infarction [HR 3.69 95% CI (1.08-12.64)] and cardiac complications [HR 2.90 95% CI (1.02-8.19)] compared with patients with a normal BP response. CONCLUSION: Patients with an abnormal BP response have more cardiovascular complications at elective major vascular surgery. |
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Authors:
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Inge I de Liefde; Gijs M J M Welten; Hence J M Verhagen; Ron T van Domburg; Robert Jan Stolker; Don Poldermans |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-9 |
Journal Detail:
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Title: Coronary artery disease Volume: - ISSN: 1473-5830 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-11 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9011445 Medline TA: Coron Artery Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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aDepartments of Anesthesiology bCardiology cVascular Surgery, Erasmus MC, Rotterdam, the Netherlands. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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