Peri-Operative Dilemmas: Dabigatran for Myocardial Injury Post-Op and Functional Capacity Assessments

Kieran Quinn and Paxton Bach kick off Season 5 of The Rounds Table with two articles surrounding peri-operative medicine – both relevant to a wide variety of health care practitioners.  The first addresses the use of dabigatran in myocardial injury after non-cardiac surgery (MINS) and the second covers assessment of functional capacity before major non-cardiac surgery.

Paxton takes listeners through the MANAGE trial in which patients were either randomized to dabigatran or placebo after MINS to examine the difference in a composite outcome of major vascular complications between the two groups.

Kieran walks listeners through the second paper which examines different assessment tools for the subjective assessment of functional capacity (such as self-reported metabolic equivalents or METs) prior to major non-cardiac surgery.  The study tells us whether or not these assessments have utility in predicting the risk of death and complications post-operatively.

Finally, the Good Stuff segment.  Paxton discusses e-cigarettes and their implications for public health. Kieran shares an article on self-applied wearable electrocardiogram patches for atrial fibrillation screening (mSTOPS trial).

Like what you hear? Rate us on iTunes!  Chat with us on twitter at @roundstable and tweet at Paxton Bach @paxbach and Kieran @kieranlquinn.

Interested in helping us evaluate our podcast episodes? We’re currently recruiting a panel of residents to serve as regular reviewers for the show. If you’re interested, email wkwong@qmed.ca.

The Papers

1. MANAGE: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30832-8/fulltext

2. Functional Capacity Assessments: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31131-0/fulltext

Good Stuff

1. E-cigarettes: https://www.npr.org/sections/health-shots/2018/06/07/615724991/he-started-vaping-as-a-teen-and-now-says-juul-is-impossible-to-let-go

2. Self-applied ECG patch: https://jamanetwork.com/journals/jama/article-abstract/2687339

Music Credits

The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

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