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Intérêt et limites des biomarqueurs cardiovasculaires en situation péri-opératoire

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Les biomarqueurs en médecine d’urgence

Part of the book series: Références en médecine d’urgence. Collection de la SFMU ((REFERMED))

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Résumé

Le vieillissement progressif de la population et la prévalence élevée des facteurs de risque cardiovasculaire au sein des pays industrialisés posent de manière cruciale le problème de lamorbimortalité péri-opératoire d’origine cardiovasculaire [1]. Ce problème représente un authentique défi de santé publique pour les anesthésistes réanimateurs et la stratification du risque opératoire s’avère plus que jamais n’cessaire. À côté des nombreux scores de risques cliniques multifactoriels dont l’utilisation au lit du patient pour la prédiction individuelle du risque cardiaque s’avère parfois difficile ou décevante, la question est posée de la pertinence des biomarqueurs et de la place qui doit éventuellement leur être accordée. Les recommandations des sociétés savantes nord-américaines [2] et européennes [3] n’accordent qu’une place limitée aux biomarqueurs tandis que les toutes récentes recommandations élaborées conjointement par la Société française d’anesthésie et de réanimation (SFAR) et la Société française de cardiologie (SFC) apportent des précisions supplémentaires intéressantes [4]. Utilisés seuls ou « en palette », les biomarqueurs cardiaques sont à l’origine d’un surcoût potentiel considérable qui ne doit pas être négligé dans une période de nécessaire maîtrise des dépenses de santé, plaidant pour une utilisation clinique rationnelle s’appuyant sur de solides données factuelles.

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Author information

Authors and Affiliations

  1. Pôle anesthésie-réanimations-SAMU, CHU de Caen, Avenue de la Côte-de-Nacre, 14033, Caen Cedex 9, France

    J.-L. Fellahi, M.-O. Fischer & G. Daccache

  2. UFR de Médecine, Université de Caen — Basse-Normandie, Caen, France

    J.-L. Fellahi, M.-O. Fischer & G. Daccache

Authors
  1. J.-L. Fellahi
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  2. M.-O. Fischer
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  3. G. Daccache
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Editors and Affiliations

  1. Département de médecine d’urgence, Centre hospitalier Princesse Grace, 1, avenue Pasteur, BP 489, MC-98012, Monaco

    Yann-Érick Claessens

  2. Hôpital Tenon Service d’accueil des urgences, UPMC-Paris 6, 4, rue de la Chine, 75020, Paris, France

    Patrick Ray

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Fellahi, JL., Fischer, MO., Daccache, G. (2012). Intérêt et limites des biomarqueurs cardiovasculaires en situation péri-opératoire. In: Claessens, YÉ., Ray, P. (eds) Les biomarqueurs en médecine d’urgence. Références en médecine d’urgence. Collection de la SFMU. Springer, Paris. https://doi.org/10.1007/978-2-8178-0297-8_39

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  • DOI: https://doi.org/10.1007/978-2-8178-0297-8_39

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0296-1

  • Online ISBN: 978-2-8178-0297-8

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