OBJECTIVES: The goal of this study was to investigate the nature of the association between silent @entity63 and @entity583 ( @entity583 ). BACKGROUND: Silent @entity63 predicts cardiac morbidity and mortality in both ambulatory and postoperative @entity1 . Whether silent stress-induced @entity63 is merely a marker of extensive @entity453 or has a closer association with @entity1188 has not been determined. METHODS: In 185 consecutive @entity1 undergoing vascular surgery, we correlated @entity63 duration, as detected on a continuous 12-lead ST-trend monitoring during the period 48 h to 72 h after surgery, with @entity6949 ( @entity6949 ) measured in the first three postoperative days and with postoperative cardiac outcome. @entity583 was defined as @entity6949 >3.1 ng/ml accompanied by either typical symptoms or new @entity63 electrocardiogram (ECG) findings. RESULTS: During 11,132 @entity1 -hours of monitoring, 38 @entity1 (20.5%) had 66 transient @entity63 events, all but one denoted by ST-segment @entity308 . Twelve @entity1 (6.5%) sustained @entity583 ; one of those @entity1 died. All @entity1188 were non-Q-wave and were detected by a rise in @entity6949 during or immediately after prolonged, ST @entity308 . The average duration ofischemia in @entity1 with @entity583 was 226+/-164 min (range: 29 to 625), compared with 38+/-26 min (p = 0.0000) in 26 @entity1 with @entity63 but not @entity1188 . Peak @entity6949 strongly correlated with the longest, as well as cumulative, @entity63 duration (r = 0.83 and r = 0.78, respectively). Ischemic ECG changes were completely reversible in all but one @entity1 who had persistent new T wave inversion. All @entity63 events culminating in @entity583 were preceded by an increase in heart rate (delta heart rate = 32+/-15 beats/min), and most (67%) of them began at the end of surgery and emergence from anesthesia. CONCLUSIONS: Prolonged, ST @entity308 progresses to MI and is strongly associated with the majority of @entity299 after vascular surgery.

@entity583 after vascular surgery: the role of prolonged stress-induced, ST XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity308 :: ('MESH:D003866', 'Disease') :: ['depression-type ischemia', 'depression'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemia', 'ischemic'] @entity6949 :: ('7137', 'Gene') :: ['cardiac troponin-I', 'cTn-I'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['infarctions', 'infarction'] @entity453 :: ('MESH:D003324', 'Disease') :: ['coronary artery disease'] @entity299 :: ('MESH:D006331', 'Disease') :: ['cardiac complications'] @entity583 :: ('MESH:D009203', 'Disease') :: ['PMI', 'Postoperative myocardial infarction', 'postoperative myocardial infarction']
@entity308 :: (MESH:D003866,Disease) :: ['depression-type ischemia']
