2012
Vascular Surgery: Endovascular and Major Vascular Surgery
Akhtar S. Vascular Surgery: Endovascular and Major Vascular Surgery. 2012, 235-253. DOI: 10.1007/978-1-4614-3888-5_16.ChaptersElderly patientsVascular surgeryAdverse eventsPerioperative managementMajor vascular surgeryPerioperative adverse eventsComplex medical historyElderly patient presentingHigh-risk procedureNoncardiac surgerySignificant comorbiditiesCardiac eventsPreoperative evaluationPatient presentingMedical historyVascular proceduresSurgeryPatientsHealthy counterpartsSignificant proportionSame age cohortAge cohortsRiskComorbiditiesEndovascular
2006
Ischemic Heart Disease
Akhtar S. Ischemic Heart Disease. Anesthesiology Clinics 2006, 24: 461-485. PMID: 17240602, DOI: 10.1016/j.atc.2006.04.002.Peer-Reviewed Original ResearchConceptsLee Cardiac Risk IndexACC/AHA guidelinesPerioperative cardiac riskPreoperative coronary revascularizationStructured management protocolCardiac Risk IndexPostoperative myocardial injuryIntraoperative anesthetic managementIschemic heart diseaseAlpha-2 agonistsLong-term outcomesRole of biomarkersNumber of patientsCoronary revascularizationNoncardiac surgeryPerioperative morbidityPostoperative morbidityAHA guidelinesAnesthetic managementCardiac riskPostoperative managementPostoperative phaseRisk stratificationMyocardial injuryHemodynamic control
2005
Intermittent Cardiac Troponin-I Screening is an Effective Means of Surveillance for a Perioperative Myocardial Infarction
Martinez EA, Nass CM, Jermyn RM, Rosenbaum SH, Akhtar S, Chan DW, Malkus H, Weiss JL, Fleisher LA. Intermittent Cardiac Troponin-I Screening is an Effective Means of Surveillance for a Perioperative Myocardial Infarction. Journal Of Cardiothoracic And Vascular Anesthesia 2005, 19: 577-582. PMID: 16202889, DOI: 10.1053/j.jvca.2005.07.002.Peer-Reviewed Original ResearchConceptsHigh diagnostic yieldPositive predictive valueDiagnosis of MIPostoperative day 1Myocardial infarctionDiagnostic yieldCardiac troponinNoncardiac surgeryCardiac injuryCreatine kinaseDay 1Surveillance strategiesIncidence of MIPerioperative cardiac injuryHigh-risk patientsPerioperative myocardial infarctionSubset of patientsIU/LGreater positive predictive valueTotal creatine kinaseCK-MB massCardiac protein markersPerioperative incidencePerioperative surveillanceCohort studyPreoperative β-blocker use: is titration to a heart rate of 60 beats per minute a consistently attainable goal?
Akhtar S, Amin M, Tantawy H, Senior A, Barash PG, Silverman DG. Preoperative β-blocker use: is titration to a heart rate of 60 beats per minute a consistently attainable goal? Journal Of Clinical Anesthesia 2005, 17: 191-197. PMID: 15896586, DOI: 10.1016/j.jclinane.2004.06.020.Peer-Reviewed Original ResearchConceptsPreinduction heart ratePerioperative beta-blocker useBeta-blocker useHeart rateCABG patientsEligible patientsSurgery patientsCoronary artery bypass graft surgeryArtery bypass graft surgeryTertiary care teaching hospitalBeta-blocker intoleranceCABG surgery patientsBeta-blocker therapyBypass graft surgeryVascular surgery patientsRetrospective observational studyUnpaired t-testBlocker groupGraft surgeryNoncardiac surgeryVascular patientsVascular surgeryTeaching hospitalObservational studyCurrent recommendations
2004
Assessment and management of patients with ischemic heart disease
Akhtar S, Silverman DG. Assessment and management of patients with ischemic heart disease. Critical Care Medicine 2004, 32: s126-s136. PMID: 15064671, DOI: 10.1097/01.ccm.0000121576.73871.2d.Peer-Reviewed Original ResearchConceptsIschemic heart diseasePerioperative cardiac morbidityHeart diseaseCardiac morbidityNoncardiac surgeryPerioperative cardiovascular outcomesPreoperative evaluation processPerioperative myocardial infarctionManagement of patientsAlpha-2 agonistsCardiac-specific biomarkersAmerican Heart AssociationIntraoperative anesthetic techniqueReview of literatureCardiovascular outcomesPerioperative managementPharmacologic therapyPostoperative managementAnesthetic techniqueHeart AssociationHemodynamic controlJoint guidelinesMyocardial infarctionAmerican CollegeHemodynamic stress