Perioperative cardioprotection in noncardiac surgery: realities and prospects

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Prevention of perioperative cardiac complications in noncardiac surgery is one of the urgent problems of modern medicine. The current data on the epidemiology of postoperative cardiac complications and their clinical and social significance have been analyzed. The efficacy and indications for perioperative cardioprotection of nitrates, calcium channel blockers, α2-agonists, inhalation anesthetics, β-blockers, statins and some other drugs have been analyzed. It was concluded that the range of recommended cardioprotectors is currently limited. The reason for this is the lack of sufficient effectiveness, but also the risk of complications. One of the most effective and safe pharmacological cardioprotectors is exogenous phosphocreatine. It has been established that myocardial ischemia-reperfusion and a number of heart diseases are accompanied by a pronounced deficiency of phosphocreatine. Modern studies have demonstrated that, in addition to the known bioenergetic properties, exogenous phosphocreatine has a complex of extracellular and intracellular effects, including antiapoptotic and antioxidant properties. A review of the main characteristics of exogenous phosphocreatine, which determines the possibility of its use as a perioperionic cardioprotector in patients with high cardiac risk, who cause noncardiac surgery, is presented.

Keywords:

phosphocreatine

cardioprotection

cardiac risk

perioperative cardiac complications

myocardial infarction

noncardiac surgery

Authors:

Kozlov I.A.

Moscow Regional Research Clinical Institute n.a. M.F. Vladimirskiy

Received:

20.05.2020

Accepted:

15.06.2020

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