Effect of Dexamethasone on Myocardial Injury After Total Knee Arthroplasty: A Substudy of the Randomized Clinical DEX-2-TKA Trial
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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.
| Original language | English |
|---|---|
| Journal | American Journal of Medicine |
| Volume | 136 |
| Issue number | 2 |
| Pages (from-to) | 193-199 |
| Number of pages | 7 |
| ISSN | 0002-9343 |
| DOIs | |
| Publication status | Published - 2023 |
Bibliographical note
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.
- Arthroplasty, Dexamethasone, Knee replacement, Troponin I, Troponin T
Research areas
ID: 370801016