Key result
Non-cardiac surgery was associated with a significant decrease in endothelial function immediately post-operatively in 3 studies, while 2 studies showed improvement at 1 month.
Why the study?
Does non-cardiac surgery affect endothelial function as measured by non-invasive markers?
Systematic Review (n=5)
Does non-cardiac surgery affect endothelial function as measured by non-invasive markers?
Non-cardiac surgery is associated with immediate post-operative endothelial dysfunction, highlighting the potential for non-invasive monitoring to guide prevention of post-operative myocardial damage.
Immediate postoperative endothelial dysfunction after non-cardiac surgery warrants monitoring; leaves open long-term recovery effects on cardiovascular risk.
BACKGROUND: More than 50% of patients with increased troponin levels after non-cardiac surgery have an impaired endothelial function pre-operatively. Non-invasive markers of endothelial function have been developed for the assessment of endothelial dysfunction. The aim of this paper was to systematically review the literature to evaluate the association between non-cardiac surgery and non-invasive markers of endothelial function. METHODS: A systematic search was conducted in MEDLINE, EMBASE and Cochrane Library Database according to the PRISMA guidelines. Endothelial dysfunction was described only with non-invasive measurements done both pre- and post-operatively and published in English. All types of non-cardiac surgery and both men and women of all ages were included. RESULTS: We found 1722 eligible studies in our search, and of these, five studies fulfilled our inclusion and exclusion criteria. Endothelial function was disturbed in patients after non-cardiac surgery. Three studies found a significant decrease in the endothelial function immediately after surgery (2 and 24 h post-operatively). Two studies found that patients with previous endothelial dysfunction and scheduled for surgery (renal transplantation and vascular surgery respectively) had an improvement in endothelial dysfunction 1 month after surgery. CONCLUSION: Endothelial function changes in relation to surgery. Assessment of endothelial function by non-invasive measures has the potential to guide clinicians in the prevention or treatment of post-operative myocardial damage.
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Søndergaard et al. (2014) conducted a systematic review in Endothelial dysfunction (n=5). Non-cardiac surgery vs. Pre-operative baseline was evaluated on Endothelial function measured by non-invasive markers. Non-cardiac surgery was associated with a significant decrease in endothelial function immediately post-operatively in 3 studies, while 2 studies showed improvement at 1 month.
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