@article{8969d2c1a7cf45a387f05dfe54f18367,
title = "Effect of Dexamethasone on Myocardial Injury After Total Knee Arthroplasty: A Substudy of the Randomized Clinical DEX-2-TKA Trial",
abstract = "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.",
keywords = "Arthroplasty, Dexamethasone, Knee replacement, Troponin I, Troponin T",
author = "M{\o}lgaard, {Asger K.} and Gasbjerg, {Kasper S.} and Meyhoff, {Christian S.} and Lunn, {Troels H.} and Jakobsen, {Janus C.} and Ismail G{\"o}genur and Ole Mathiesen and Daniel H{\"a}gi-Pedersen",
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 N{\ae}stved, 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 N{\ae}stved, Slagelse, and Ringsted (NSR) Hospitals Research Fund and the Departments of Anesthesiology at NSR Hospitals and Bispebjerg Hospital. Publisher Copyright: {\textcopyright} 2022 Elsevier Inc.",
year = "2023",
doi = "10.1016/j.amjmed.2022.09.031",
language = "English",
volume = "136",
pages = "193--199",
journal = "American Journal of Medicine",
issn = "0002-9343",
publisher = "Elsevier",
number = "2",
}