title: Sleep apnea in total joint arthroplasty patients and the role for cardiac biomarkers for risk stratification: an exploration of feasibility.
abstract: Obstructive sleep apnea (OSA) is highly prevalent in patients undergoing total joint arthroplasty (TJA) and is a major risk factor for postoperative cardiovascular complications and death. Recognizing this, the American Society of Anesthesiologists urges clinicians to implement special considerations in the perioperative care of OSA patients. However, as the volume of patients presenting for TJA increases, resources to implement these recommendations are limited. This necessitates mechanisms to efficiently risk stratify patients having OSA who may be susceptible to post-TJA cardiovascular complications. We explore the role of perioperative measurement of cardiac troponins (cTns) and brain natriuretic peptides (BNPs) in helping determine which OSA patients are at increased risk for post-TJA cardiovascular-related morbidity.
authors.affiliation: Division of Sleep Medicine, Center for Sleep & Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.|Department of Biobehavioral Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: M Melanie
authors.initials: MM
authors.lastname: Lyons
authors.affiliation: Division of Pulmonary, Allergy, Critical Care & Sleep Medicine, The Ohio State University, Columbus, OH, USA.
authors.forename: Nitin Y
authors.initials: NY
authors.lastname: Bhatt
authors.affiliation: Division of Sleep Medicine, Center for Sleep & Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kneeland-Szanto
authors.affiliation: Division of Sleep Medicine, Center for Sleep & Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Brendan T
authors.initials: BT
authors.lastname: Keenan
authors.affiliation: Department of Penn Orthopaedics, Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, PA, USA.
authors.forename: Joanne
authors.initials: J
authors.lastname: Pechar
authors.affiliation: Division of Sleep Medicine, Center for Sleep & Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Branden
authors.initials: B
authors.lastname: Stearns
authors.affiliation: Department of Anesthesiology & Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Nabil M
authors.initials: NM
authors.lastname: Elkassabany
authors.affiliation: Department of Anesthesiology & Public Health, Weill Cornell Medical College & Department of Anesthesiology, Hospital for Special Surgery, New York, NY, USA.
authors.forename: Stavros G
authors.initials: SG
authors.lastname: Memtsoudis
authors.affiliation: Division of Sleep Medicine, Center for Sleep & Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Allan I
authors.initials: AI
authors.lastname: Pack
authors.affiliation: Division of Sleep Medicine, Center for Sleep & Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.|Division of Sleep Medicine, CMC VA Medical Center, Philadelphia, PA, USA.
authors.forename: Indira
authors.initials: I
authors.lastname: Gurubhagavatula
mesh_terms: D001178:Arthroplasty; D015415:Biomarkers / Q000378:metabolism*; D005240:Feasibility Studies; D006801:Humans; D009206:Myocardium / Q000378:metabolism*; D011183:Postoperative Complications / Q000209:etiology; D018570:Risk Assessment; D020181:Sleep Apnea, Obstructive / Q000378:metabolism*
chemical_list: D015415:Biomarkers
keywords: brain natriuretic peptide; obstructive sleep apnea; postoperative complications; total joint arthroplasty; troponin