The diagnosis of spinal cord injury (SCI) remains associated with a poor prognosis due to limited treatment options and the absence of curative therapies. Optimizing treatment strategies is therefore crucial to enhance patients’ quality of life, reduce mortality and re-hospitalization rates, and lower overall therapy costs. Shock wave therapy (SWT) is a well-established regenerative treatment option for pathologies of the musculoskeletal system that delivers high-energy acoustic waves. SWT is non-invasive, safe and cost-effective. Preclinical and clinical evidence is emerging, showing the efficacy of SWT in the treatment of both traumatic and ischemic SCI. This systematic review synthesizes evidence on SWT in SCI from 2000 to 2025, excluding case reports and non-regenerative applications. Results were categorized into preclinical and clinical studies, with preclinical findings further divided into functional, histological, cellular, and molecular outcomes. Promising preclinical results led to initial clinical studies, which demonstrated the safety and feasibility of SWT, with a randomized controlled trial currently ongoing (ClinicalTrials.gov: NCT04474106). Overall, the encouraging evidence suggests that SWT is a promising novel regenerative treatment option for SCI, although further research is needed to define optimal treatment protocols and to establish its role in standard clinical care.

Objectives Mitral valve (MV) disease shows sex-specific differences in morphology and outcomes. Women often present later, undergo replacement more frequently, and experience worse survival. This study investigated sex-related disparities in surgical approach, repair rates, and outcomes of MV surgery. Methods A total of 1531 consecutive patients undergoing MV surgery with or without concomitant tricuspid valve procedure were analysed retrospectively. Baseline characteristics, operative strategies, and outcomes were compared between sexes. Propensity score matching was used to adjust for baseline differences. Primary outcomes were 30-day and 5-year mortality. Baseline and procedural characteristics, including morphology, repair rates, use of minimally invasive MV surgery (MIMVS), and concomitant tricuspid disease, were compared between groups. Results Female patients (44%) were older (68 vs 62 years, P < .001), more symptomatic (New York Heart Association [NYHA] III: 60% vs 46%, P < .001), and more likely to have annular calcification (15% vs 5%, P < .001) or concomitant tricuspid disease (25% vs 36%, P < .001). Carpentier type IIIa was more prevalent in women (21% vs 4%), while type II predominated in men (75% vs 49%). MIMVS and repair were less frequent in women (49% vs 65% and 67% vs 85%, both P < .001). Female sex was associated with increased 30-day (HR 4.07, 95% CI 1.51-11.0; P = .006) and 5-year mortality (HR 1.58, 1.02-2.46; P = .043). After adjusting for morphology and calcification, sex was no longer an independent predictor of repair rates or long-term mortality. Conclusions Women present at a later stage of the disease and with more complex MV pathology, resulting in lower repair and MIMVS rates and higher perioperative mortality. These disparities are largely attributable to disease morphology rather than sex per se. Earlier referral of women is essential to improve outcomes.

BACKGROUND:The use of artificial chords for mitral valve prolapse during minimally invasive mitral valve repair (MIMVR) has increased over the past two decades, driven by advancements in surgical techniques and the need for reproducible and durable repair strategies. This study aimed to compare the outcomes of single artificial chords versus premeasured loops and identify predictors for long-term success. METHODS:Between 2001-2023, perioperative data and long-term outcomes of 1186 consecutive patients who underwent MIMVR at the University Hospital Innsbruck, Austria were analysed and reported according to the Mitral Valve Research Consortium criteria, including all-cause mortality, freedom from reoperation and technical success defined as freedom from reoperation or recurrent mitral regurgitation>moderate. A competing risk analysis was performed to account for the risk of mortality long-term. RESULTS:The mean age of the cohort was 60.6±12.6 years, with 61.6% males. Among them, 581 patients received artificial chords (151 single chords and 430 premeasured loops). At a median follow-up of 5.0 (4.45-5.53) years, survival was 98.4%, 95.4% and 92.7% at 1, 5 and 10 years, respectively. At 15 years, cumulative incidence of death or reoperation was 8.5% in the loop group and 11.0% in the single expanded polytetrafluoroethylene (ePTFE) chord group (p=0.90), with a hazard ratio of 0.95 (95% CI 0.44 to 2.06). The loop technique was associated with shorter cross-clamp times (100 vs 121 min, p<0.001) and more implanted chords (5.0 vs 2.0, p<0.001) compared with the ePTFE chord technique. There was no significant difference in long-term success: event-free survival at 10 years: 92% (87-97%) in the loops group versus 93% (89-97%) in the single ePTFE chords group, p=0.5. Left atrial appendage occlusion emerged as the only independent predictor for long-term success (HR: 0.11 (0.014-0.839), p=0.033), whereas the choice of technique did not influence long-term outcomes. CONCLUSIONS:Both single artificial chords and premeasured loops provided excellent perioperative and long-term outcomes in MIMVR. The loop technique facilitated shorter operative times and greater chordal implantation efficiency without compromising long-term repair durability or event-free survival.

OBJECTIVES:Commissural prolapse (CP) is a rare and complex mitral valve pathology which is complicated in preoperative diagnosis and repair. This study evaluated the safety, success, and long-term efficacy of minimally invasive mitral valve repair (MIMVR) for CP compared to posterior leaflet prolapse (PMLp). METHODS:Between 2001 and 2022, 34 patients with CP and 590 with PMLp underwent MIMVR at our center. Operative, perioperative, and long-term follow-up data were retrospectively collected. Surgical success was defined as freedom from conversion to valve replacement, sternotomy, and residual mitral regurgitation (MR) > grade I. Long-term efficacy included MR recurrence, reoperation, and survival. RESULTS:Median age was similar (CP: 64.0 years [53.2; 69.8] vs PMLp: 62.0 years [53.0; 69.0], p = 0.783). Barlow's disease was more frequent in PMLp (80.3% vs 32.4%, p < 0.001). Cross-clamp (127.0 min vs 105.0 min, p = 0.001) and bypass times (208.5 min vs 190.5 min, p = 0.031) were longer in CP. CP patients had longer hospital stays (10.0 days [8.0; 12.0] vs 8.0 days [7.0; 9.0], p < 0.001), but short-term outcomes, including 30-day mortality, stroke, and ECMO support, were comparable. At a median follow-up of 4.5 years (CP) and 2.4 years (PMLp, p = 0.001), rates of recurrent MR, reoperation, and survival were similar. CONCLUSIONS:MIMVR for CP is safe, successful, and durable with outcomes comparable to PMLp. Despite greater technical complexity and longer operative times, this approach provides reliable results for CP.

OBJECTIVES:This study aimed to identify intraoperative and perioperative factors influencing 30-day mortality after cardiac surgery and to develop a risk score (POP-score) for its prediction. DESIGN:Retrospective cohort study with multivariable regression analysis. SETTING:A tertiary care cardiac surgery centre in Austria; data from consecutive patients undergoing cardiac surgery between 2010 and 2020 were analysed. PARTICIPANTS:A total of 8072 patients were included. The cohort was randomly divided into a derivation cohort (75%) and a validation cohort (25%). OUTCOME MEASURES:The primary outcome measure was 30-day mortality. We analysed associations between intraoperative and perioperative variables and 30-day mortality, assessed via multivariable regression analysis. RESULTS:Several factors were significantly associated with 30-day mortality, including intraoperative RBC transfusion (OR 3.407 (95% CI 2.124-5.464)), postoperative high-sensitive cardiac troponin T cut-off levels (OR 2.856 (95% CI 1.958 to 4.165)), need for dialysis/haemofiltration (OR 2.958 (95% CI 2.013 to 4.348)) and temporary extracorporeal membrane oxygenation support (OR 5.218 (95% CI 3.329 to 8.179)) (p<0.001 for all). The newly developed POP-score demonstrated superior predictive performance for 30-day mortality compared with the EuroSCORE II alone (area under the ROC curve (AUC) 0.884 vs 0.800, p=0.013), based on peak troponin values assessed within the first 7 postoperative days. As 98% of peak troponin elevations occurred within 72 hours, the POP-score can be calculated at this earlier time point for clinical implementation. CONCLUSIONS:The validated POP-score provides an improved tool for predicting 30-day mortality after cardiac surgery by incorporating intraoperative and perioperative factors alongside the EuroSCORE II. Although model performance was evaluated using 7-day peak troponin data, the score can be calculated within the first 72 hours postoperatively in most patients, supporting its clinical applicability for early decision-making, resource allocation and patient counselling. Further research is warranted to assess its clinical utility in diverse populations.

Aims:Cardiac shockwave therapy (SWT) improves left ventricular (LV) function in patients with ischaemic cardiomyopathy. Shockwave therapy activates Toll-like receptor 3 (TLR3), a receptor-inducing chromatin remodelling and nuclear reprogramming of cardiac cells. We hypothesized that mechanical activation of TLR3 facilitates reprogramming of fibroblasts towards endothelial cells restoring myocardial perfusion and function. Methods and results:Human cardiac fibroblasts were treated by mechanical stimulation via SWT or TLR3 agonist Poly(I:C) in the presence of endothelial induction medium. A lineage tracing experiment was performed in a transgenic mouse model of Fsp1-Cre/LacZ mice after coronary occlusion. Left ventricular function and scarring were assessed. Single-cell sequencing including RNA trajectory analysis was performed. Chromatin remodelling and epigenetic plasticity were evaluated via western blot and Assay for Transposase-Accessible Chromatin sequencing. Mechanical stimulation of human fibroblasts with SWT activated TLR3 signalling and enhanced the expression of endothelial genes in a TLR3-dependent fashion. The induced endothelial cells (ECs) resembled genuine ECs in that they produced endothelial nitric oxide and formed tube-like structures in Matrigel. In a lineage tracing experiment in Fsp1-Cre/LacZ mice, shockwave treatment increased LacZ/CD31-positive cells (indicating transdifferentiation) after coronary occlusion. Furthermore, SWT reduced myocardial scar size and improved LV function. Single-cell RNA-seq and RNA trajectory analyses revealed that SWT induced an endothelial fibroblast cluster and mechanical stimulation induced significant changes in chromatin organization, with chromatin being more accessible after both treatments in 1705 genomic regions. Conclusion:Shockwave therapy enhances DNA accessibility via TLR3 activation and facilitates the transdifferentiation of fibroblasts towards endothelial cells in ischaemic myocardium.

BACKGROUND:High levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) reflect poor cardiac status in heart failure patients. OBJECTIVES:This study analyzed the association of preoperative NT-proBNP dynamics with 30-day and 5-year mortality after cardiac surgery. METHODS:A consecutive cohort of 6,938 patients undergoing cardiac surgery was analyzed. The relationship between preoperative NT-proBNP levels and 30-day and 5-year mortality (median follow up time: 4.53 [2.00-5.00] years) adjusted for EuroSCORE II was explored with a Cox proportional hazards model. The dynamics of preoperative NT-proBNP levels were analyzed by comparing the values at diagnosis or assignment to surgery with the values on the day before surgery (n = 4,739). Results were validated in an external cohort from the SWEDEHEART registry (n = 3,117). RESULTS:Median preoperative NT-proBNP concentration was 552 (208-1,591) ng/L. Death within 30 days occurred in 2.1% (149/6,938) of the population. High preoperative NT-proBNP levels were associated with higher 30-day and 5-year mortality. Initial high NT-proBNP at diagnosis, with subsequent decrease in preoperative NT-proBNP below 3,000 ng/L, was associated with more favorable perioperative outcomes after adjustment for EuroSCORE II shorter stays in intensive care unit (OR: 0.60, 95% CI: 0.44-0.82), less use of ultrafiltration (OR: 0.48, 95% CI: 0.33-0.70), or extracorporeal membrane oxygenation (OR: 0.26, 95% CI: 0.12-0.57; all P < 0.001) and lower 30-day mortality (HR: 0.21, 95% CI: 0.07-0.61; P = 0.004). Five-year survival was improved in patients with decreases in preoperative NT-proBNP levels (log-rank: P < 0.001, HR: 0.44, 95% CI: 0.30-0.65). CONCLUSIONS:Reductions in NT-proBNP levels before surgery were associated with lower 30-day and 5-year mortality after cardiac surgery. Patients with high NT-proBNP concentrations may benefit from preoperative optimization to lower NT-proBNP.

OBJECTIVE:Perioperative stroke associated with coronary artery bypass grafting (CABG) is a catastrophic event. Identification of patients at risk and reduction of its incidence remains of high importance. The aim of this study was to analyse the association of different degrees of asymptomatic carotid artery stenosis (CAS) with the perioperative outcome in a consecutive series of CABG patients and to identify predictors for CABG associated ischaemic stroke. METHODS:In total, 2727 patients undergoing isolated CABG procedure at the Medical University of Innsbruck between 2010 and 2020 were included in this study. Sonography data included the severity of carotid stenosis for left and right internal carotid artery individually. The primary outcome was the 30-day stroke and mortality rate, and the secondary outcome was 5-year mortality. A Cox regression model was performed after adjustment for EuroSCORE II. RESULTS:Left CAS>50% was present in 177 patients (7%) and right CAS>50% in 197 patients (7.8%). In total, 1.6% (40 patients) of the patients died within 30 days after surgery, and 1.0% (24 patients) experienced a postoperative stroke within 30 days. Patients with a carotid stenosis>90% had a higher 30-day mortality (p<0.001) and higher incidence of postoperative stroke within 30 days (p=0.005). Patients with a history of a prior stroke were at higher risk of experiencing another stroke within 30-days after surgery, with an HR of 6.829 (2.811-16.589) (p<0.001). CONCLUSIONS:Asymptomatic CAS>90% and history of stroke are both independent risk factors for perioperative stroke and 30-day mortality.

BACKGROUND The impact of sex-differences on the release of cardiac biomarkers after coronary artery bypass grafting (CABG) remains unknown. The aim of our study was to (1) investigate the impact of sex-differences in cardiac biomarker release after CABG and (2) determine sex-specific thresholds for high-sensitivity cardiac troponin (hs-cTn) and creatine kinase-myocardial band (CKMB) associated with 30-day major adverse cardiovascular events (MACE) and mortality. METHODS A consecutive cohort of 3687 patients, comprising 643 women (17.4%) and 3044 men (82.6%), undergoing CABG from 2008 to 2021 in 2 tertiary university centers with serial postoperative cTn and CK-MB measurement was analyzed. The composite primary outcome was MACE at 30 days. Secondary end points were 30-day mortality and 5-year mortality and MACE. Sex-specific thresholds for cTn and CK-MB were determined. RESULTS Lower levels of cTn were found in women after CABG (69.18 vs 77.57 times the upper reference limit [URL]; P < .001). The optimal threshold value for cTn was calculated at 94.36 times the URL for female patients and 206.07 times the URL for male patients to predict 30-day MACE. Female patients missed by a general threshold had increased risk for MACE or death within 30 days (cTn: MACE: odds ratio [OR], 3.78; 95% CI, 1.03-13.08; P = .035; death: OR, 4.98; 95% CI, 1.20-20.61; P = .027; CK-MB: MACE: OR, 10.04; 95% CI, 2.07-48.75; P < .001; death: OR 13.59; 95% CI, 2.66-69.47; P = .002). CONCLUSIONS We provide evidence for sex-specific differences in the outcome and biomarker release after CABG. Sex-specific cutoffs are necessary for the diagnosis of perioperative myocardial injury to improve outcomes of women after CABG. (Ann Thorac Surg 2025;119:120-8) (c) 2024 The Authors. Published by Elsevier Inc. on behalf of The Society of Thoracic Surgeons. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

BACKGROUND:Elevated preoperative hs-cTnT may reflect underlying myocardial vulnerability, potentially influencing surgical timing and perioperative strategies in patients undergoing elective coronary artery bypass grafting (CABG). OBJECTIVES:This study investigates the association between preoperative hs-cTnT levels, perioperative outcomes, and long-term mortality, aiming to improve risk stratification and guide clinical decision-making. METHODS:This retrospective study analyzed a consecutive series of 5,450 patients undergoing CABG at 2 tertiary centers between 2010 and 2023. Patients were categorized into 3 groups based on preoperative hs-cTnT levels: 1) nonelevated (<1x upper reference limit [URL]); 2) mildly elevated (1-3x URL); and 3) significantly elevated (>3x URL). A propensity score weighting method was performed before evaluating the association of hs-cTnT with perioperative outcomes, 30-day mortality and 5-year mortality. RESULTS:Among elective CABG patients, 26.6% had hs-cTnT levels >1x URL, and 12.4% had levels >3x URL. Patients with significantly elevated hs-cTnT (>3x URL) demonstrated increased risks of extracorporeal membrane oxygenation use (HR: 2.96 [95% CI: 1.81-4.84]), hemofiltration (HR: 2.99 [95% CI: 2.27-3.94]), and 5-year mortality (HR: 1.55 [95% CI: 1.28-1.86]) (all P < 0.001). Even mild elevations (1-3x URL) were linked to higher rates of hemofiltration (HR: 2.25 [1.75-2.90]; P < 0.001), extracorporeal membrane oxygenation use (HR: 1.65 [95% CI: 1.01-2.69]; P = 0.046), and 5-year mortality (HR: 1.37 [95% CI: 1.14-1.34]; P < 0.001). CONCLUSIONS:Preoperative hs-cTnT is an independent predictor of adverse outcomes in elective CABG. Integrating hs-cTnT into routine preoperative assessment could identify high-risk patients, optimize surgical timing, and determine whether patients may benefit more from CABG or percutaneous coronary intervention, ultimately improving clinical outcomes.

Background: With 1.4 billion people worldwide affected by elevated lipoprotein(a) [Lp(a)] concentrations, it has emerged as a critical player in the realm of cardiovascular health. Lp(a) is an established independent risk factor for coronary heart disease and became a recently recognized factor for aortic valve stenosis. This study aims to investigate the impact of elevated Lp(a) on the long-term outcomes following cardiac surgery.

OBJECTIVES: Myocardial hypertrophy results in increased levels of cardiac biomarkers in healthy individuals and in patients suffering from acute myocardial infarction. The influence of cardiac mass on postoperative cardiac biomarkers release remains unclear. This study investigated the correlation between myocardial mass and the release of high-sensitivity cardiac Troponin T (hs-cTnT) and creatine kinase-myocardial band (CK-MB) after isolated aortic valve replacement (AVR) or bypass surgery.METHODS: Myocardial mass of a consecutive retrospective series of patients was measured automatically using preoperative computer tomography scans (636 patients, AVR = 251; bypass surgery = 385). Levels of cardiac biomarkers were measured before and serially after surgery. Spearman and Pearson correlation and a multivariate regression model was performed to measure the degree of association between myocardial mass and the release of hs-cTnT and CK-MB.RESULTS: Patients were divided into 3 tertiles according to their myocardial mass index. Higher biomarker levels were measured preoperatively in the upper tertile of patients undergoing AVR (P = 0.004) or bypass surgery (P < 0.001). Patients with different heart sizes showed no differences in postoperative biomarker release neither after AVR nor bypass surgery. No statistical significant correlation was observed between myocardial mass index and postoperative release of hs-cTnT or CK-MB in any subgroup (rho maximum 0.106).CONCLUSIONS: Postoperative biomarker release is not correlated with myocardial mass. Patient factors leading to increased postoperative biomarker levels need to be elucidated in future studies.

The human’s heart responds to tissue damage with persistent fibrotic scarring. Unlike humans, zebrafish exhibit the ability to repair cardiac injury and re-grow heart tissue throughout life. Here, we provide novel evidence for toll-like receptor 3 (tlr3) driving cardiac regeneration in zebrafish. Upon cardiac injury, survival is decreased in tlr3-/- fish as compared to wildtype controls. Tlr3-/- zebrafish fail to recruit innate immune cells to the injured ventricle, resulting in impaired DNA repair and transcriptional reprogramming of cardiomyocytes. Mechanistically, we uncover an evolutionary conserved mechanism of tlr3 activation in fibroblasts promoting monocyte migration towards an injured ventricular area. Our data reveal tlr3 as a novel therapeutic target to promote cardiac regeneration.

Abstract Background Elevated levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) reflect cardiac status in heart failure patients and are independently associated with mortality and adverse cardiovascular outcomes in elective patients undergoing non-cardiac surgery. However, there is scarce evidence about the association between NT-proBNP and outcome after cardiac surgery in large patient populations. Purpose The aim of this study was to analyze the association of preoperative NT-pro-BNP levels with 30-day and five-year mortality after cardiac surgery. Methods A consecutive cohort of 6938 patients undergoing cardiac surgery was analyzed retrospectively. The relationship between preoperative NT-proBNP and 30-day and five-year mortality adjusted for EuroSCORE II was explored using a Cox proportional hazards model. The dynamics of preoperative NT-proBNP were analyzed by comparing the values at the time of diagnosis or assignment to surgery with the values on the day before surgery (n= 4739). Results were validated in an external cohort from the SWEDEHEART registry (n=3415). Results Median preoperative NT-proBNP was 552 ng/l. Death within 30 days occurred in 2.1% of the patients. High preoperative NT-proBNP levels were associated with a higher 30-dayand 5-yearmortality. Preoperative NT-proBNP thresholds to identify patients at high-risk (>4000 ng/l), intermediate-risk (2000-4000 ng/l) and low-risk (<2000 ng/l) for 30-day mortality were determined. Patients in the intermediate or high-risk category had a higher risk for prolonged ICU stay (OR 2.52), ultrafiltration (OR 3.68), ECMO (OR 3.63), 30-day mortality (HR 2.79), and 5-year mortality (HR 2.41) (p-value all <0.001). Patients who improved in the preoperative NT-proBNP risk had a significant 30-day and five-year survival benefit. Conclusions Preoperative NT-proBNP levels are independently associated with 30-day and five-year mortality after cardiac surgery. NT-proBNP reduction prior to surgery might decrease 30-day and five-year mortality after cardiac surgery.NTproBNP is associated with outcome

Background and Aims In chronic ischaemic heart failure, revascularisation strategies control symptoms but are less effective in improving left ventricular ejection fraction (LVEF). The aim of this trial is to investigate the safety of cardiac shockwave therapy (SWT) as a novel treatment option and its efficacy in increasing cardiac function by inducing angiogenesis and regeneration in hibernating myocardium.Methods In this single-blind, parallel-group, sham-controlled trial (cardiac shockwave therapy for ischemic heart failure, CAST-HF; NCT03859466) patients with LVEF <= 40% requiring surgical revascularisation were enrolled. Patients were randomly assigned to undergo direct cardiac SWT or sham treatment in addition to coronary bypass surgery. The primary efficacy endpoint was the improvement in LVEF measured by cardiac magnetic resonance imaging from baseline to 360 days.Results Overall, 63 patients were randomized, out of which 30 patients of the SWT group and 28 patients of the Sham group attained 1-year follow-up of the primary endpoint. Greater improvement in LVEF was observed in the SWT group (Delta from baseline to 360 days: SWT 11.3%, SD 8.8; Sham 6.3%, SD 7.4, P = .0146). Secondary endpoints included the 6-minute walking test, where patients randomized in the SWT group showed a greater Delta from baseline to 360 days (127.5 m, SD 110.6) than patients in the Sham group (43.6 m, SD 172.1) (P = .028) and Minnesota Living with Heart Failure Questionnaire score on day 360, which was 11.0 points (SD 19.1) for the SWT group and 17.3 points (SD 15.1) for the Sham group (P = .15). Two patients in the treatment group died for non-device-related reasons.Conclusions In conclusion, the CAST-HF trial indicates that direct cardiac SWT, in addition to coronary bypass surgery improves LVEF and physical capacity in patients with ischaemic heart failure. Structured Graphical Abstract Direct cardiac shockwave therapy (SWT) in addition to coronary artery bypass graft (CABG) surgery improves left ventricular ejection fraction (LVEF), physical capacity and quality of life in patients with ischaemic heart failure. 6MWT, 6-min walking test; FUP, follow-up; GDMT, guideline-directed medical therapy; NYHA, New York Heart Association; iCMP, ischaemic cardiomyopathy

ObjectiveIn patients with complex coronary artery disease (CAD) undergoing cardiac surgery, myocardial protection might be impaired due to microvascular obstruction, resulting in myocardial injury and subsequent biomarker release. Therefore, this study investigated the correlation between the complexity of CAD, reflected by the SYNTAX Score, and the release of cardiac biomarkers after CABG.MethodsIn a consecutive series of 919 patients undergoing isolated CABG SYNTAX scores I and II were calculated to assess the complexity of CAD. Levels of high sensitivity cardiac troponin T (hs-cTnT) and creatine kinase-myocardial band (CK-MB) were routinely measured once before and serially after surgery. Patients were divided into tertiles according to their SYNTAX Scores I and II. Spearman correlations and regression models were performed to measure the degree of association between the release of hs-cTnT and CK-MB and the SYNTAX Scores.ResultsPatients with a higher SYNTAX Score I had more comorbidities reflected in a higher EuroSCORE II. Preoperatively, higher levels of cardiac biomarkers were found in patients with higher SYNTAX Score II. No correlation was observed between hs-cTnT, CK-MB and SYNTAX Score I or II. Regression models did not show any association between cardiac biomarkers and the complexity of CAD.ConclusionThe complexity of CAD is not associated with the release of cardiac biomarkers after CABG. Factors influencing postoperative biomarker release need to be elucidated in future trials to include postoperative biomarker release into risk stratification models predicting outcome after cardiac surgery.

BACKGROUND:Patients with heart failure are at risk of perioperative complications with elective cardiac surgery. OBJECTIVES:Conception of a multidisciplinary telemedicine-assisted optimisation project for high-risk patients prior to elective cardiac surgery. METHODS:Multidisciplinary concept design. RESULTS:A pilot-project for 30 patients was developed. CONCLUSION:Design of the first preoperative telemonitoring-assisted optimisation project for high-risk patients undergoing cardiac surgery.