2017
Association of red blood cell transfusion and short- and longer-term mortality after coronary artery bypass graft surgery
Tantawy H, Li A, Dai F, Elgammal M, Sukumar N, Elefteriades J, Akhtar S. Association of red blood cell transfusion and short- and longer-term mortality after coronary artery bypass graft surgery. Journal Of Cardiothoracic And Vascular Anesthesia 2017, 32: 1225-1232. PMID: 29402623, DOI: 10.1053/j.jvca.2017.12.033.Peer-Reviewed Original ResearchConceptsCoronary artery bypass graft surgeryPacked red blood cellsArtery bypass graft surgeryRed blood cell transfusionTertiary care academic medical centerBypass graft surgeryBlood cell transfusionAcademic medical centerMortality rateCABG surgeryCell transfusionGraft surgeryMedical CenterAdult cardiac surgery patientsLong-term mortality outcomesRetrospective medical record reviewCardiothoracic intensive care unitPropensity Score Matching AnalysisCardiac surgery patientsLong-term mortalityMedical record reviewIntensive care unitSignificant differencesStatistical significant differenceHospital mortality
2014
Case 3–2015 Preventing Adverse Outcomes in the Very Elderly Cardiac Surgical Patients
Akhtar S, Morris B, Roy R, Balogun SA. Case 3–2015 Preventing Adverse Outcomes in the Very Elderly Cardiac Surgical Patients. Journal Of Cardiothoracic And Vascular Anesthesia 2014, 29: 510-521. PMID: 25440648, DOI: 10.1053/j.jvca.2014.07.014.Peer-Reviewed Original Research
2010
Coronary stents: factors contributing to perioperative major adverse cardiovascular events
Barash P, Akhtar S. Coronary stents: factors contributing to perioperative major adverse cardiovascular events. British Journal Of Anaesthesia 2010, 105: i3-i15. PMID: 21148653, DOI: 10.1093/bja/aeq318.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsAdverse cardiovascular eventsCardiovascular eventsStent thrombosisRisk factorsPerioperative major adverse cardiovascular eventsContinuation of aspirinDual antiplatelet therapyNon-cardiac surgeryRisk of bleedingPercutaneous coronary interventionCoronary blood flowMajor risk factorDominant risk factorBare metal stentsDrug-eluting stentsNeuraxial anesthetic techniquesHigh mortality rateClopidogrel therapyAntiplatelet therapyCoronary interventionEpidural haematomaElective surgeryAnesthetic techniqueMyocardial ischaemiaScientific Principles and Clinical Implications of Perioperative Glucose Regulation and Control
Akhtar S, Barash PG, Inzucchi SE. Scientific Principles and Clinical Implications of Perioperative Glucose Regulation and Control. Anesthesia & Analgesia 2010, 110: 478-497. PMID: 20081134, DOI: 10.1213/ane.0b013e3181c6be63.Peer-Reviewed Original ResearchMeSH KeywordsBlood GlucoseGlucoseHumansHyperglycemiaHypoglycemiaInsulinInsulin ResistanceInsulin SecretionIntraoperative ComplicationsPerioperative CarePostoperative ComplicationsSignal TransductionConceptsIntensive glycemic controlGlycemic controlPerioperative periodPostsurgical patientsAcute insulin resistanceClose glucose monitoringPerioperative glycemic controlRecent prospective trialsDevelopment of hyperglycemiaRisk of hypoglycemiaIntraoperative glycemic controlNeuroendocrine stress responseGlycemic targetsProspective trialIll patientsIntraoperative managementPoor outcomeInsulin resistanceImproved outcomesTrue efficacyGlucose levelsGlucose regulationHyperglycemiaPatientsClinical implications
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 study
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
1999
The Effect of Heart Rate Control on Myocardial Ischemia Among High-Risk Patients After Vascular Surgery
Raby K, Brull S, Timimi F, Akhtar S, Rosenbaum S, Naimi C, Whittemore A. The Effect of Heart Rate Control on Myocardial Ischemia Among High-Risk Patients After Vascular Surgery. Anesthesia & Analgesia 1999, 88: 477-482.. DOI: 10.1213/00000539-199903000-00002.Peer-Reviewed Original ResearchConceptsHeart rate controlMean heart ratePostoperative cardiac eventsHigh-risk patientsST-segment depressionIschemic thresholdPostoperative ischemiaMyocardial ischemiaVascular surgeryHeart rateCardiac eventsEsmolol patientsPlacebo patientsPreoperative ischemiaCardiac complicationsHigh riskHigh-risk vascular surgery patientsBeta-adrenergic blocker therapyMajor postoperative cardiac eventsStrict heart rate controlElective vascular surgeryIncidence of ischemiaPostoperative heart ratePostoperative myocardial ischemiaPreoperative myocardial ischemiaThe effect of heart rate control on myocardial ischemia among high-risk patients after vascular surgery.
Raby K, Brull S, Timimi F, Akhtar S, Rosenbaum S, Naimi C, Whittemore A. The effect of heart rate control on myocardial ischemia among high-risk patients after vascular surgery. Anesthesia & Analgesia 1999, 88: 477-82. PMID: 10071990, DOI: 10.1097/00000539-199903000-00002.Peer-Reviewed Original ResearchConceptsHeart rate controlMean heart ratePostoperative cardiac eventsHigh-risk patientsST-segment depressionIschemic thresholdPostoperative ischemiaMyocardial ischemiaVascular surgeryHeart rateCardiac eventsEsmolol patientsPlacebo patientsPreoperative ischemiaCardiac complicationsHigh riskHigh-risk vascular surgery patientsBeta-adrenergic blocker therapyMajor postoperative cardiac eventsStrict heart rate controlElective vascular surgeryIncidence of ischemiaPostoperative heart ratePostoperative myocardial ischemiaPreoperative myocardial ischemia