Faculty Bibliography
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221
Influence of Diabetes on Trends in Perioperative Cardiovascular Events
OBJECTIVE:Patients undergoing noncardiac surgery frequently have diabetes mellitus (DM) and an elevated risk of cardiovascular disease. It is unknown whether temporal declines in the frequency of perioperative major adverse cardiovascular and cerebrovascular events (MACCEs) apply to patients with DM. RESEARCH DESIGN AND METHODS/METHODS:Patients ≥45 years of age who underwent noncardiac surgery from January 2004 to December 2013 were identified using the U.S. National Inpatient Sample. DM was identified using ICD-9 diagnosis codes. Perioperative MACCEs (in-hospital all-cause mortality, acute myocardial infarction, or acute ischemic stroke) by DM status were evaluated over time. RESULTS:for interaction <0.001). Trends for individual end points were all less favorable for patients with DM versus those without DM. CONCLUSIONS:In an analysis of >10.5 million noncardiac surgeries from a large U.S. hospital admission database, perioperative MACCEs were more common among patients with DM versus without DM. Perioperative MACCEs increased over time and individual end points were all less favorable for patients with DM. Our findings suggest that a substantial unmet need exists for strategies to reduce the risk of perioperative cardiovascular events among patients with DM.
PMCID:5961401
PMID: 29618572
ISSN: 1935-5548
CID: 3025302
Hospital Readmission After Perioperative Acute Myocardial Infarction Associated With Noncardiac Surgery
PMCID:5995321
PMID: 29525764
ISSN: 1524-4539
CID: 2994102
Coronary angiography in patients with perioperative myocardial injury after non-cardiac surgery [Meeting Abstract]
Background: Perioperative myocardial infarction (MI) is a common cardiovascular complication of surgery that occurs in up to 5.0% of patients at increased cardiovascular risk. We sought to determine coronary artery anatomy in patients referred for invasive coronary angiography for the evaluation of perioperative MI or myocardial injury after non-cardiac surgery (MINS). Methods: Patients with perioperative MI or MINS who were referred for coronary angiography at NYU Langone Medical Center were retrospectively identified from January 1, 2013 to December 31, 2015. Demographic, clinical, and angiographic characteristics were obtained via electronic medical record review. Results: A total of 31 patients with perioperative MI (n=28) or MINS (n=3) were referred for invasive coronary angiography. The mean age was 70+/-10 years, 52% were male, and cardiovascular risk factors were common (Table). Obstructive coronary artery disease (CAD) was identified in 24 patients (77.4%) and a chronic total occlusion (CTO) of a major epicardial vessel was identified in 11 patients. A total of 15 patients (48.4%) underwent PCI. Among patients without obstructive CAD, angiography revealed mild CAD (stenosis <40% in major epicardial coronary vessels) in the majority (71.4%) of cases. Conclusion: Obstructive CAD is present in the majority of patients with perioperative MI or MINS, with CTO in nearly half of these patients. One-quarter of patients did not have obstructive CAD, and the mechanism of myocardial injury in these patients is unknown. This study reaffirms the benefit of empiric guidelinedirected medical therapy for CAD in patients with perioperative MI or MINS, despite limited evidence from clinical trials in this population
EMBASE:622145773
ISSN: 1522-726x
CID: 3130492
Controversies Surrounding Authorship of Manuscripts by Industry Employees: Academic and Industry Perspectives
AIMS/OBJECTIVE:The medical device and pharmaceutical industries play an essential role in the development of cardiovascular devices and drugs, and industry employees are frequently listed as co-authors of clinical trials published in peer-reviewed journals. Potential conflicts of interest in biomedical research have attracted significant attention in recent years, but issues and challenges surrounding authors who are industry employees have not received nearly as much scrutiny. METHODS AND RESULTS/RESULTS:We present a comprehensive discussion of the concerns and challenges regarding the role of industry in the authorship of scientific manuscripts. Academic co-authors, industry employees, the editors of medical journals, and, most importantly, readers, need to consider the perception and implications that accompany industry employee authorship. Potential concerns include the effect of industry authors (and industry support) on study design, data analysis, interpretations, conclusions, and, ultimately, scientific content. CONCLUSIONS:Meaningful contributions from industry employees must be acknowledged and reported in scientific and clinical publications. Efforts to provide full transparency on industry support and the role of industry contributors are necessary to maintain confidence in the reports of studies with industry involvement.
PMID: 29278351
ISSN: 1969-6213
CID: 2895952
HOSPITAL READMISSION FOLLOWING PERIOPERATIVE ACUTE MYOCARDIAL INFARCTION ASSOCIATED WITH NON-CARDIAC SURGERY [Meeting Abstract]
ISI:000429659705123
ISSN: 0735-1097
CID: 3055212
ASSOCIATIONS BETWEEN CONVENTIONAL CARDIOVASCULAR RISK FACTORS AND RISK OF PERIOPERATIVE ACUTE MYOCARDIAL INFARCTION AFTER NON-CARDIAC SURGERY [Meeting Abstract]
ISI:000429659703516
ISSN: 0735-1097
CID: 3055252
THE IMPACT OF CARDIOVASCULAR DISEASE RISK FACTORS ON ATHEROSCLEROSIS IN PSORIASIS [Meeting Abstract]
ISI:000429659703510
ISSN: 0735-1097
CID: 3055262
LEFT VENTRICULAR WALL MOTION FINDINGS IN MYOCARDIAL INFARCTION WITH NONOBSTRUCTIVE CORONARY ARTERY DISEASE (MINOCA) [Meeting Abstract]
ISI:000429659700136
ISSN: 0735-1097
CID: 3055342
ACUTE MYOCARDIAL INFARCTION DURING PREGNANCY AND THE PUERPERIUM IN THE UNITED STATES [Meeting Abstract]
ISI:000429659700006
ISSN: 0735-1097
CID: 3055362
Letter by Smilowitz Regarding Article, "Three-Vessel Assessment of Coronary Microvascular Dysfunction in Patients With Clinical Suspicion of Ischemia: Prospective Observational Study With the Index of Microcirculatory Resistance" [Letter]
PMCID:5798473
PMID: 29386189
ISSN: 1941-7632
CID: 2933402
