Observational studyJournal of thrombosis and thrombolysis2026
Association of thrombogenicity indices with perioperative cardiovascular events after non-cardiac surgery: a prespecified analysis of the PANDA study.
Observational study in Journal of thrombosis and thrombolysis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02250963 (Prognostic Accuracy of Coronary CT and Dobutamine Stress Echocardiography in Patient Undergoing Non-cardiac Surgery), which is not on this map. Not yet cited in PubMed.
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Prognostic Accuracy of Coronary CT and Dobutamine Stress Echocardiography in Patient Undergoing Non-cardiac Surgery
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11 authors.
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Abstract
Traditional clinical risk models, such as Revised Cardiac Risk Index (RCRI), have limited predictive value for estimating postoperative cardiovascular complications following non-cardiac surgery. This analysis aimed to evaluate prognostic value of thrombogenicity profiles and coronary anatomy for cardiovascular events in patients undergoing non-cardiac surgery. In a prospective cohort of 120 patients who underwent intermediate-to-high risk surgery, thrombogenicity profiles were assessed using thromboelastography (TEG®) and conventional hemostatic measurements before surgery. Coronary artery disease (CAD) was preoperatively defined as presence of significant stenosis (≥ 50% luminal narrowing) on coronary computed tomography angiography (CCTA). Postoperative cardiovascular events were defined as cardiovascular death, non-fatal myocardial infarction, myocardial injury, pulmonary edema, non-fatal stroke, and systemic embolism within 30 days after surgery. Sixteen patients (13.3%) experienced cardiovascular events. In multivariable analysis, presence of CAD (odds ratio [OR]: 5.11; 95% confidence interval [CI]: 1.49-17.53; P = 0.009), D-dimer (per 1-μg/mL increase: OR: 1.22; 95% CI: 1.02-1.47; P = 0.030), and platelet-fibrin clot strength (PFCS) measured by TEG® (per 1-mm increase: OR: 1.10; 95% CI: 1.01-1.20; P = 0.027) were independently associated with cardiovascular events. Discrimination of cardiovascular event risk improved progressively with the sequential addition of the following risk stratification models: RCRI alone, RCRI + CCTA, and RCRI + CCTA + thrombogenicity profiles (C-index: 0.660 vs. 0.731 vs. 0.803). Cardiovascular event rates increased with greater risk burden, ranging from 4.2% in patients with no risk components to 77.8% in those with all components present. Integrating thrombogenicity assessment and CCTA with traditional clinical risk models may improve perioperative risk stratification and help guide tailored preventive strategies for patients undergoing non-cardiac surgery.Clinical trial registration. URL: http://www.clinicaltrials.gov . Unique identifier: NCT02250963.
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