Effect of Dexamethasone on Myocardial Injury After Total Knee Arthroplasty: A Substudy of the Randomized Clinical DEX-2-TKA Trial
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Effect of Dexamethasone on Myocardial Injury After Total Knee Arthroplasty : A Substudy of the Randomized Clinical DEX-2-TKA Trial. / Mølgaard, Asger K.; Gasbjerg, Kasper S.; Meyhoff, Christian S.; Lunn, Troels H.; Jakobsen, Janus C.; Gögenur, Ismail; Mathiesen, Ole; Hägi-Pedersen, Daniel.
I: American Journal of Medicine, Bind 136, Nr. 2, 2023, s. 193-199.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Effect of Dexamethasone on Myocardial Injury After Total Knee Arthroplasty
T2 - A Substudy of the Randomized Clinical DEX-2-TKA Trial
AU - Mølgaard, Asger K.
AU - Gasbjerg, Kasper S.
AU - Meyhoff, Christian S.
AU - Lunn, Troels H.
AU - Jakobsen, Janus C.
AU - Gögenur, Ismail
AU - Mathiesen, Ole
AU - Hägi-Pedersen, Daniel
N1 - Funding Information: Conflicts of Interest : AKM, KSG, THL, JCJ, IG, OM, and DH-P report none. CSM reports being a cofounder of a start-up company, WARD247 ApS, with the aim of pursuing the regulatory and commercial activities of the WARD-project (wireless assessment of vital signs). WARD247 ApS has finalized terms for license agreement for any WARD-project software and patents. One patent has been filed: “Wireless Assessment of Respiratory and circulatory Distress (WARD) – Clinical Support System (CSS) – an automated clinical support system to improve patient safety and outcomes” and also reports direct and indirect research funding from Merck Sharp & Dohme Corp., Radiometer and Boehringer Ingelheim, as well as lecture fees from Radiometer, all outside the submitted work. Funding Information: Funding: Analyses were funded by a grant from the Næstved, Slagelse, and Ringsted (NSR) Hospitals Research Fund and the Departments of Anesthesiology at NSR Hospitals and Bispebjerg Hospital. Conflicts of Interest: AKM, KSG, THL, JCJ, IG, OM, and DH-P report none. CSM reports being a cofounder of a start-up company, WARD247 ApS, with the aim of pursuing the regulatory and commercial activities of the WARD-project (wireless assessment of vital signs). WARD247 ApS has finalized terms for license agreement for any WARD-project software and patents. One patent has been filed: “Wireless Assessment of Respiratory and circulatory Distress (WARD) – Clinical Support System (CSS) – an automated clinical support system to improve patient safety and outcomes” and also reports direct and indirect research funding from Merck Sharp & Dohme Corp., Radiometer and Boehringer Ingelheim, as well as lecture fees from Radiometer, all outside the submitted work. Funding Information: Funding: Analyses were funded by a grant from the Næstved, Slagelse, and Ringsted (NSR) Hospitals Research Fund and the Departments of Anesthesiology at NSR Hospitals and Bispebjerg Hospital. Publisher Copyright: © 2022 Elsevier Inc.
PY - 2023
Y1 - 2023
N2 - Background: Myocardial injury after noncardiac surgery (MINS) carries a high postoperative mortality. In this preplanned, subgroup analysis of the randomized DEX-2-TKA Trial, we investigated the effect of dexamethasone versus placebo on the concentration of cardiac troponin I and T (TnI and TnT) on the first postoperative morning after total knee arthroplasty. In addition, frequency of MINS, myocardial infarction, and major adverse cardiovascular events where evaluated. Methods: We included 290 patients who received either 24 mg of dexamethasone intravenously (given perioperatively) or placebo. Blood samples were analyzed as either TnI or T depending on trial site. Results: A total of 236 samples were eligible for analysis of TnI and 38 samples for TnT on the first postoperative morning. The median (IQR) TnI concentration was 4.6 ng/L (0-7.2 ng/L) in the dexamethasone group and 4.5ng/l (0-7.0 ng/L) in the placebo group (P = .96) on the first postoperative morning. The median TnT was 9 ng/L (6-11 ng/L) in the dexamethasone group and 8 ng/L (5-10 ng/L) in the placebo group (P = .68). The frequencies of MINS, myocardial infarction, and major adverse cardiovascular events were similar in the compared groups, but these analyses were underpowered. Conclusion: We found no effect of dexamethasone on postoperative concentration of troponin I or T on the first postoperative morning after total knee arthroplasty.
AB - Background: Myocardial injury after noncardiac surgery (MINS) carries a high postoperative mortality. In this preplanned, subgroup analysis of the randomized DEX-2-TKA Trial, we investigated the effect of dexamethasone versus placebo on the concentration of cardiac troponin I and T (TnI and TnT) on the first postoperative morning after total knee arthroplasty. In addition, frequency of MINS, myocardial infarction, and major adverse cardiovascular events where evaluated. Methods: We included 290 patients who received either 24 mg of dexamethasone intravenously (given perioperatively) or placebo. Blood samples were analyzed as either TnI or T depending on trial site. Results: A total of 236 samples were eligible for analysis of TnI and 38 samples for TnT on the first postoperative morning. The median (IQR) TnI concentration was 4.6 ng/L (0-7.2 ng/L) in the dexamethasone group and 4.5ng/l (0-7.0 ng/L) in the placebo group (P = .96) on the first postoperative morning. The median TnT was 9 ng/L (6-11 ng/L) in the dexamethasone group and 8 ng/L (5-10 ng/L) in the placebo group (P = .68). The frequencies of MINS, myocardial infarction, and major adverse cardiovascular events were similar in the compared groups, but these analyses were underpowered. Conclusion: We found no effect of dexamethasone on postoperative concentration of troponin I or T on the first postoperative morning after total knee arthroplasty.
KW - Arthroplasty
KW - Dexamethasone
KW - Knee replacement
KW - Troponin I
KW - Troponin T
U2 - 10.1016/j.amjmed.2022.09.031
DO - 10.1016/j.amjmed.2022.09.031
M3 - Journal article
C2 - 36252718
AN - SCOPUS:85143498986
VL - 136
SP - 193
EP - 199
JO - American Journal of Medicine
JF - American Journal of Medicine
SN - 0002-9343
IS - 2
ER -
ID: 370801016