Myocardial Injury after Noncardiac Surgery A Large, International, Prospective Cohort Study Establishing Diagnostic Criteria, Characteristics, Predictors, and 30-day Outcomes
Por:
Botto, F, Alonso-Coello, P, Chan, MTV, Villar, JC, Xavier, D, Srinathan, S, Guyatt, G, Cruz, P, Graham, M, Wang, CY, Berwanger, O, Pearse, RM, Biccard, BM, Abraham, V, Malaga, G, Hillis, GS, Rodseth, RN, Cook, D, Polanczyk, CA, Szczeklik, W, Sessler, DI, Sheth, T, Ackland, GL, Leuwer, M, Garg, AX, LeManach, Y, Pettit, S, Heels-Ansdell, D, LuratiBuse, G, Walsh, M, Sapsford, R, Schunemann, HJ, Kurz, A, Thomas, S, Mrkobrada, M, Thabane, L, Gerstein, H, Paniagua, P, Nagele, P, Raina, P, Yusuf, S, Devereaux, PJ, McQueen, MJ, Bhandari, M, Bosch, J, Buckley, N, Chow, CK, Halliwell, R, Li, S, Lee, VW, Mooney, J, Furtado, MV, Suzumura, E, Santucci, E, Leite, K, Santo, JAD, Cavalcanti, AB, Guimaraes, HP, Jacka, MJ, McAlister, F, McMurtry, S, Townsend, D, Pannu, N, Bagshaw, S, Bessissow, A, Duceppe, E, Eikelboom, J, Ganame, J, Hankinson, J, Hill, S, Jolly, S, Lamy, A, Ling, E, Magloire, P, Pare, G, Szalay, D, Tittley, J, Weitz, J, Whitlock, R, Darvish-Kazim, S, DeBeer, J, Kavsak, P, Kearon, C, Mizera, R, O'Donnell, M, McQueen, M, Pinthus, J, Ribas, S, Simunovic, M, Tandon, V, VanHelder, T, Winemaker, M, McDonald, S, O'Bryne, P, Patel, A, Paul, J, Punthakee, Z, Raymer, K, Salehian, O, Spencer, F, Walter, S, Worster, A, Adili, A, Clase, C, Crowther, M, Douketis, J, Gangji, A, Jackson, P, Lim, W, Lovrics, P, Mazzadi, S, Orovan, W, Rudkowski, J, Soth, M, Tiboni, M, Acedillo, R, Garg, A, Hildebrand, A, Lam, N, MacNeil, D, Roshanov, PS, Srinathan, SK, Ramsey, C, St John, P, Thorlacius, L, Siddiqui, FS, Grocott, HP, McKay, A, Lee, TWR, Amadeo, R, Funk, D, McDonald, H, Zacharias, J, Villar, JC, Cortes, OL, Chaparro, MS, Vasquez, S, Castaneda, A, Ferreira, S, Coriat, P, Monneret, D, Goarin, JP, Esteve, CI, Royer, C, Daas, G, Choi, GYS, Gin, T, Lit, LCW, Sigamani, A, Faruqui, A, Dhanpal, R, Almeida, S, Cherian, J, Furruqh, S, Afzal, L, George, P, Mala, S, Schunemann, H, Muti, P, Vizza, E, Ong, GSY, Mansor, M, Tan, ASB, Shariffuddin, II, Vasanthan, V, Hashim, NHM, Undok, AW, Ki, U, Lai, HY, Ahmad, WA, Razack, AHA, Valderrama-Victoria, V, Loza-Herrera, JD, Lazo, MD, Rotta-Rotta, A, Sokolowska, B, Musial, J, Gorka, J, Iwaszczuk, P, Kozka, M, Chwala, M, Raczek, M, Mrowiecki, T, Kaczmarek, B, Biccard, B, Cassimjee, H, Gopalan, D, Kisten, T, Mugabi, A, Naidoo, P, Naidoo, R, Rodseth, R, Skinner, D, Torborg, A, Urrutia, G, Maestre, ML, Santalo, M, Gonzalez, R, Font, A, Martinez, C, Pelaez, X, De Antonio, M, Villamor, JM, Garcia, JA, Ferre, MJ, Popova, E, Garutti, I, Fernandez, C, Palencia, M, Diaz, S, del Castillo, T, Varela, A, de Miguel, A, Munoz, M, Pineiro, P, Cusati, G, del Barrio, M, Membrillo, MJ, Orozco, D, Reyes, F, Sapsford, RJ, Barth, J, Scott, J, Hall, A, Howell, S, Lobley, M, Woods, J, Howard, S, Fletcher, J, Dewhirst, N, Williams, C, Rushton, A, Welters, I, Leuwer, M, Pearse, R, Ackland, G, Khan, A, Niebrzegowska, E, Benton, S, Wragg, A, Archbold, A, Smith, A, McAlees, E, Ramballi, C, MacDonald, N, Januszewska, M, Stephens, R, Reyes, A, GallegoParedes, L, Sultan, P, Cain, D, Whittle, J, del Arroyo, AG, Sun, Z, Finnegan, PS, Egan, C, Honar, H, Shahinyan, A, Panjasawatwong, K, Fu, AY, Wang, S, Reineks, E, Blood, J, Kalin, M, Gibson, D, Wildes, T
Publicada:
1 mar 2014
Resumen:
Background: Myocardial injury after noncardiac surgery (MINS) was defined as prognostically relevant myocardial injury due to ischemia that occurs during or within 30 days after noncardiac surgery. The study's four objectives were to determine the diagnostic criteria, characteristics, predictors, and 30-day outcomes of MINS.
Methods: In this international, prospective cohort study of 15,065 patients aged 45 yr or older who underwent in-patient noncardiac surgery, troponin T was measured during the first 3 postoperative days. Patients with a troponin T level of 0.04 ng/ml or greater (elevated abnormal laboratory threshold) were assessed for ischemic features (i.e., ischemic symptoms and electrocardiography findings). Patients adjudicated as having a nonischemic troponin elevation (e.g., sepsis) were excluded. To establish diagnostic criteria for MINS, the authors used Cox regression analyses in which the dependent variable was 30-day mortality (260 deaths) and independent variables included preoperative variables, perioperative complications, and potential MINS diagnostic criteria.
Results: An elevated troponin after noncardiac surgery, irrespective of the presence of an ischemic feature, independently predicted 30-day mortality. Therefore, the authors' diagnostic criterion for MINS was a peak troponin T level of 0.03 ng/ml or greater judged due to myocardial ischemia. MINS was an independent predictor of 30-day mortality (adjusted hazard ratio, 3.87; 95% CI, 2.96-5.08) and had the highest population-attributable risk (34.0%, 95% CI, 26.6-41.5) of the perioperative complications. Twelve hundred patients (8.0%) suffered MINS, and 58.2% of these patients would not have fulfilled the universal definition of myocardial infarction. Only 15.8% of patients with MINS experienced an ischemic symptom.
Conclusion: Among adults undergoing noncardiac surgery, MINS is common and associated with substantial mortality.
Filiaciones:
Botto, F:
Populat Hlth Res Inst, Hamilton, ON, Canada
Estudios Clin Latino Amer, Dept Clin Res, Rosario, Santa Fe, Argentina
Alonso-Coello, P:
Biomed Res Inst St Pau IIB St Pau, Barcelona, Spain
Chan, MTV:
Chinese Univ Hong Kong, Shatin, Hong Kong, Peoples R China
Villar, JC:
Univ Autonoma Bucaramanga, Bucaramanga, Colombia
Xavier, D:
St Johns Med Coll & Res Inst, Bangalore, Karnataka, India
Srinathan, S:
Univ Manitoba, Dept Surg, Winnipeg, MB R3T 2N2, Canada
Winnipeg Hlth Sci Ctr, Winnipeg, MB, Canada
Guyatt, G:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
McMaster Univ, Dept Med, Hamilton, ON, Canada
Cruz, P:
Univ Gregorio Maranon, Gen Hosp, Madrid, Spain
Graham, M:
Univ Alberta, Edmonton, AB, Canada
Wang, CY:
Univ Malaya, Kuala Lumpur, Malaysia
Berwanger, O:
Hosp Coracao, Res Inst HCor, Sao Paulo, Brazil
Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, BR-90046900 Porto Alegre, RS, Brazil
Pearse, RM:
Barts & London Queen Marys Sch Med & Dent, London, England
Biccard, BM:
Univ Kwazulu Natal, Durban, South Africa
Abraham, V:
Christian Med Coll & Hosp, Ludhiana, Punjab, India
Malaga, G:
Univ PeruanaCayetano Heredia, Lima, Peru
Hillis, GS:
Univ Sydney, George Inst Global Hlth, Sydney, NSW 2006, Australia
Rodseth, RN:
Populat Hlth Res Inst, Hamilton, ON, Canada
Univ Kwazulu Natal, Durban, South Africa
Cook, D:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
McMaster Univ, Dept Med, Hamilton, ON, Canada
St Josephs Hlth Care, Hamilton, ON, Canada
Polanczyk, CA:
Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, BR-90046900 Porto Alegre, RS, Brazil
Szczeklik, W:
Jagiellonian Univ, Coll Med, Krakow, Poland
Sessler, DI:
Cleveland Clin, Cleveland, OH 44106 USA
Sheth, T:
Populat Hlth Res Inst, Hamilton, ON, Canada
McMaster Univ, Dept Med, Hamilton, ON, Canada
Hamilton Hlth Sci Ctr, Juravinski Hosp & Canc Ctr, Hamilton, ON, Canada
Ackland, GL:
UCL, London, England
Leuwer, M:
Univ Liverpool, Inst Translat Med, Liverpool L69 3BX, Merseyside, England
Garg, AX:
London Hlth Sci Ctr, London, ON, Canada
LeManach, Y:
Populat Hlth Res Inst, Hamilton, ON, Canada
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
McMaster Univ, Dept Anesthesia, Hamilton, ON, Canada
Univ Paris 06, Grp Hosp Pitie Salpetriere, Dept Anesthesiol & Crit Care, Paris, France
Pettit, S:
Populat Hlth Res Inst, Hamilton, ON, Canada
Heels-Ansdell, D:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
LuratiBuse, G:
Populat Hlth Res Inst, Hamilton, ON, Canada
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Walsh, M:
Populat Hlth Res Inst, Hamilton, ON, Canada
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
McMaster Univ, Dept Med, Hamilton, ON, Canada
Sapsford, R:
Leeds Teaching Hosp, Leeds, W Yorkshire, England
Schunemann, HJ:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
McMaster Univ, Dept Med, Hamilton, ON, Canada
Kurz, A:
Cleveland Clin, Cleveland, OH 44106 USA
Thomas, S:
Populat Hlth Res Inst, Hamilton, ON, Canada
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Mrkobrada, M:
Populat Hlth Res Inst, Hamilton, ON, Canada
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
London Hlth Sci Ctr, London, ON, Canada
Victoria Hosp, London Hlth Sci Ctr, London, ON, Canada
Thabane, L:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Gerstein, H:
Populat Hlth Res Inst, Hamilton, ON, Canada
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
McMaster Univ, Dept Med, Hamilton, ON, Canada
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Paniagua, P:
Biomed Res Inst St Pau IIB St Pau, Barcelona, Spain
Biomed Res Inst St Pau, Barcelona, Spain
Nagele, P:
Washington Univ, Sch Med, St Louis, MO USA
Raina, P:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Yusuf, S:
Populat Hlth Res Inst, Hamilton, ON, Canada
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
McMaster Univ, Dept Med, Hamilton, ON, Canada
Devereaux, PJ:
Populat Hlth Res Inst, Hamilton, ON, Canada
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
McMaster Univ, Dept Med, Hamilton, ON, Canada
McQueen, MJ:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Bhandari, M:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
McMaster Univ, Dept Surg, Hamilton, ON L8S 4L8, Canada
Bosch, J:
Populat Hlth Res Inst, Hamilton, ON, Canada
Buckley, N:
McMaster Univ, Dept Anesthesia, Hamilton, ON, Canada
Chow, CK:
Univ Sydney, George Inst Global Hlth, Sydney, NSW 2006, Australia
Halliwell, R:
Univ Sydney, George Inst Global Hlth, Sydney, NSW 2006, Australia
Li, S:
Univ Sydney, George Inst Global Hlth, Sydney, NSW 2006, Australia
Lee, VW:
Univ Sydney, George Inst Global Hlth, Sydney, NSW 2006, Australia
Mooney, J:
Univ Sydney, George Inst Global Hlth, Sydney, NSW 2006, Australia
Furtado, MV:
Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, BR-90046900 Porto Alegre, RS, Brazil
Suzumura, E:
Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, BR-90046900 Porto Alegre, RS, Brazil
Santucci, E:
Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, BR-90046900 Porto Alegre, RS, Brazil
Leite, K:
Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, BR-90046900 Porto Alegre, RS, Brazil
Santo, JAD:
Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, BR-90046900 Porto Alegre, RS, Brazil
Cavalcanti, AB:
Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, BR-90046900 Porto Alegre, RS, Brazil
Guimaraes, HP:
Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, BR-90046900 Porto Alegre, RS, Brazil
Jacka, MJ:
Univ Alberta, Edmonton, AB, Canada
McAlister, F:
Univ Alberta, Edmonton, AB, Canada
McMurtry, S:
Univ Alberta, Edmonton, AB, Canada
Townsend, D:
Univ Alberta, Edmonton, AB, Canada
Pannu, N:
Univ Alberta, Edmonton, AB, Canada
Bagshaw, S:
Univ Alberta, Edmonton, AB, Canada
Bessissow, A:
Populat Hlth Res Inst, Hamilton, ON, Canada
Duceppe, E:
Populat Hlth Res Inst, Hamilton, ON, Canada
Eikelboom, J:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Ganame, J:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Hankinson, J:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Hill, S:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Jolly, S:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Lamy, A:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Ling, E:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Magloire, P:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Pare, G:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Szalay, D:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Tittley, J:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Weitz, J:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Whitlock, R:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Darvish-Kazim, S:
Hamilton Hlth Sci Ctr, Juravinski Hosp & Canc Ctr, Hamilton, ON, Canada
DeBeer, J:
Hamilton Hlth Sci Ctr, Juravinski Hosp & Canc Ctr, Hamilton, ON, Canada
Kavsak, P:
Hamilton Hlth Sci Ctr, Juravinski Hosp & Canc Ctr, Hamilton, ON, Canada
Kearon, C:
Hamilton Hlth Sci Ctr, Juravinski Hosp & Canc Ctr, Hamilton, ON, Canada
Mizera, R:
Hamilton Hlth Sci Ctr, Juravinski Hosp & Canc Ctr, Hamilton, ON, Canada
O'Donnell, M:
Hamilton Hlth Sci Ctr, Juravinski Hosp & Canc Ctr, Hamilton, ON, Canada
McQueen, M:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
Hamilton Hlth Sci Ctr, Juravinski Hosp & Canc Ctr, Hamilton, ON, Canada
Pinthus, J:
Hamilton Hlth Sci Ctr, Juravinski Hosp & Canc Ctr, Hamilton, ON, Canada
Ribas, S:
Hamilton Hlth Sci Ctr, Juravinski Hosp & Canc Ctr, Hamilton, ON, Canada
Simunovic, M:
Hamilton Hlth Sci Ctr, Juravinski Hosp & Canc Ctr, Hamilton, ON, Canada
Tandon, V:
Hamilton Hlth Sci Ctr, Juravinski Hosp & Canc Ctr, Hamilton, ON, Canada
VanHelder, T:
Hamilton Hlth Sci Ctr, Juravinski Hosp & Canc Ctr, Hamilton, ON, Canada
Winemaker, M:
Hamilton Hlth Sci Ctr, Juravinski Hosp & Canc Ctr, Hamilton, ON, Canada
McDonald, S:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
McMaster Univ, Med Ctr, Hamilton, ON L8S 4L8, Canada
O'Bryne, P:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
McMaster Univ, Med Ctr, Hamilton, ON L8S 4L8, Canada
Patel, A:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
McMaster Univ, Med Ctr, Hamilton, ON L8S 4L8, Canada
Paul, J:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
McMaster Univ, Med Ctr, Hamilton, ON L8S 4L8, Canada
Punthakee, Z:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
McMaster Univ, Med Ctr, Hamilton, ON L8S 4L8, Canada
Raymer, K:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
McMaster Univ, Med Ctr, Hamilton, ON L8S 4L8, Canada
Salehian, O:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
McMaster Univ, Med Ctr, Hamilton, ON L8S 4L8, Canada
Spencer, F:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
McMaster Univ, Med Ctr, Hamilton, ON L8S 4L8, Canada
Walter, S:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
McMaster Univ, Med Ctr, Hamilton, ON L8S 4L8, Canada
Worster, A:
Hamilton Hlth Sci Ctr, Hamilton, ON, Canada
McMaster Univ, Med Ctr, Hamilton, ON L8S 4L8, Canada
Adili, A:
St Josephs Hlth Care, Hamilton, ON, Canada
Clase, C:
St Josephs Hlth Care, Hamilton, ON, Canada
Crowther, M:
St Josephs Hlth Care, Hamilton, ON, Canada
Douketis, J:
St Josephs Hlth Care, Hamilton, ON, Canada
Gangji, A:
St Josephs Hlth Care, Hamilton, ON, Canada
Jackson, P:
St Josephs Hlth Care, Hamilton, ON, Canada
Lim, W:
St Josephs Hlth Care, Hamilton, ON, Canada
Lovrics, P:
St Josephs Hlth Care, Hamilton, ON, Canada
Mazzadi, S:
St Josephs Hlth Care, Hamilton, ON, Canada
Orovan, W:
St Josephs Hlth Care, Hamilton, ON, Canada
Rudkowski, J:
St Josephs Hlth Care, Hamilton, ON, Canada
Soth, M:
St Josephs Hlth Care, Hamilton, ON, Canada
Tiboni, M:
St Josephs Hlth Care, Hamilton, ON, Canada
Acedillo, R:
Victoria Hosp, London Hlth Sci Ctr, London, ON, Canada
Garg, A:
London Hlth Sci Ctr, London, ON, Canada
Victoria Hosp, London Hlth Sci Ctr, London, ON, Canada
Hildebrand, A:
Victoria Hosp, London Hlth Sci Ctr, London, ON, Canada
Lam, N:
Victoria Hosp, London Hlth Sci Ctr, London, ON, Canada
MacNeil, D:
Victoria Hosp, London Hlth Sci Ctr, London, ON, Canada
Roshanov, PS:
Victoria Hosp, London Hlth Sci Ctr, London, ON, Canada
Srinathan, SK:
Winnipeg Hlth Sci Ctr, Winnipeg, MB, Canada
Ramsey, C:
Winnipeg Hlth Sci Ctr, Winnipeg, MB, Canada
St John, P:
Winnipeg Hlth Sci Ctr, Winnipeg, MB, Canada
Thorlacius, L:
Winnipeg Hlth Sci Ctr, Winnipeg, MB, Canada
Siddiqui, FS:
Winnipeg Hlth Sci Ctr, Winnipeg, MB, Canada
Grocott, HP:
Winnipeg Hlth Sci Ctr, Winnipeg, MB, Canada
McKay, A:
Winnipeg Hlth Sci Ctr, Winnipeg, MB, Canada
Lee, TWR:
Winnipeg Hlth Sci Ctr, Winnipeg, MB, Canada
Amadeo, R:
Winnipeg Hlth Sci Ctr, Winnipeg, MB, Canada
Funk, D:
Winnipeg Hlth Sci Ctr, Winnipeg, MB, Canada
McDonald, H:
Winnipeg Hlth Sci Ctr, Winnipeg, MB, Canada
Zacharias, J:
Winnipeg Hlth Sci Ctr, Winnipeg, MB, Canada
Villar, JC:
Univ Autonoma Bucaramanga, Bucaramanga, Colombia
Cortes, OL:
Univ Autonoma Bucaramanga, Bucaramanga, Colombia
Chaparro, MS:
Univ Autonoma Bucaramanga, Bucaramanga, Colombia
Vasquez, S:
Univ Autonoma Bucaramanga, Bucaramanga, Colombia
Castaneda, A:
Univ Autonoma Bucaramanga, Bucaramanga, Colombia
Ferreira, S:
Univ Autonoma Bucaramanga, Bucaramanga, Colombia
Coriat, P:
Univ Paris 06, Hosp Pitie Salpetriere, Paris, France
Monneret, D:
Univ Paris 06, Hosp Pitie Salpetriere, Paris, France
Goarin, JP:
Univ Paris 06, Hosp Pitie Salpetriere, Paris, France
Esteve, CI:
Univ Paris 06, Hosp Pitie Salpetriere, Paris, France
Royer, C:
Univ Paris 06, Hosp Pitie Salpetriere, Paris, France
Daas, G:
Univ Paris 06, Hosp Pitie Salpetriere, Paris, France
Choi, GYS:
Chinese Univ Hong Kong, Shatin, Hong Kong, Peoples R China
Gin, T:
Chinese Univ Hong Kong, Shatin, Hong Kong, Peoples R China
Lit, LCW:
Chinese Univ Hong Kong, Shatin, Hong Kong, Peoples R China
Sigamani, A:
St Johns Med Coll & Res Inst, Bangalore, Karnataka, India
Faruqui, A:
St Johns Med Coll & Res Inst, Bangalore, Karnataka, India
Dhanpal, R:
St Johns Med Coll & Res Inst, Bangalore, Karnataka, India
Almeida, S:
St Johns Med Coll & Res Inst, Bangalore, Karnataka, India
Cherian, J:
St Johns Med Coll & Res Inst, Bangalore, Karnataka, India
Furruqh, S:
St Johns Med Coll & Res Inst, Bangalore, Karnataka, India
Afzal, L:
Christian Med Coll & Hosp, Ludhiana, Punjab, India
George, P:
Christian Med Coll & Hosp, Ludhiana, Punjab, India
Mala, S:
Christian Med Coll & Hosp, Ludhiana, Punjab, India
Schunemann, H:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
McMaster Univ, Dept Med, Hamilton, ON, Canada
Natl Canc Inst Regina Elena, Rome, Italy
Muti, P:
Natl Canc Inst Regina Elena, Rome, Italy
Vizza, E:
Natl Canc Inst Regina Elena, Rome, Italy
Ong, GSY:
Univ Malaya, Kuala Lumpur, Malaysia
Mansor, M:
Univ Malaya, Kuala Lumpur, Malaysia
Tan, ASB:
Univ Malaya, Kuala Lumpur, Malaysia
Shariffuddin, II:
Univ Malaya, Kuala Lumpur, Malaysia
Vasanthan, V:
Univ Malaya, Kuala Lumpur, Malaysia
Hashim, NHM:
Univ Malaya, Kuala Lumpur, Malaysia
Undok, AW:
Univ Malaya, Kuala Lumpur, Malaysia
Ki, U:
Univ Malaya, Kuala Lumpur, Malaysia
Lai, HY:
Univ Malaya, Kuala Lumpur, Malaysia
Ahmad, WA:
Univ Malaya, Kuala Lumpur, Malaysia
Razack, AHA:
Univ Malaya, Kuala Lumpur, Malaysia
Valderrama-Victoria, V:
Univ PeruanaCayetano Heredia, Lima, Peru
Loza-Herrera, JD:
Univ PeruanaCayetano Heredia, Lima, Peru
Lazo, MD:
Univ PeruanaCayetano Heredia, Lima, Peru
Rotta-Rotta, A:
Univ PeruanaCayetano Heredia, Lima, Peru
Sokolowska, B:
Jagiellonian Univ, Coll Med, Krakow, Poland
Musial, J:
Jagiellonian Univ, Coll Med, Krakow, Poland
Gorka, J:
Jagiellonian Univ, Coll Med, Krakow, Poland
Iwaszczuk, P:
Jagiellonian Univ, Coll Med, Krakow, Poland
Kozka, M:
Jagiellonian Univ, Coll Med, Krakow, Poland
Chwala, M:
Jagiellonian Univ, Coll Med, Krakow, Poland
Raczek, M:
Jagiellonian Univ, Coll Med, Krakow, Poland
Mrowiecki, T:
Jagiellonian Univ, Coll Med, Krakow, Poland
Kaczmarek, B:
Jagiellonian Univ, Coll Med, Krakow, Poland
Biccard, B:
Univ Kwazulu Natal, Durban, South Africa
Cassimjee, H:
Univ Kwazulu Natal, Durban, South Africa
Gopalan, D:
Univ Kwazulu Natal, Durban, South Africa
Kisten, T:
Univ Kwazulu Natal, Durban, South Africa
Mugabi, A:
Univ Kwazulu Natal, Durban, South Africa
Naidoo, P:
Univ Kwazulu Natal, Durban, South Africa
Naidoo, R:
Univ Kwazulu Natal, Durban, South Africa
Rodseth, R:
Populat Hlth Res Inst, Hamilton, ON, Canada
Univ Kwazulu Natal, Durban, South Africa
Skinner, D:
Univ Kwazulu Natal, Durban, South Africa
Torborg, A:
Univ Kwazulu Natal, Durban, South Africa
Urrutia, G:
Biomed Res Inst St Pau, Barcelona, Spain
Maestre, ML:
Biomed Res Inst St Pau, Barcelona, Spain
Santalo, M:
Biomed Res Inst St Pau, Barcelona, Spain
Gonzalez, R:
Biomed Res Inst St Pau, Barcelona, Spain
Font, A:
Biomed Res Inst St Pau, Barcelona, Spain
Martinez, C:
Biomed Res Inst St Pau, Barcelona, Spain
Pelaez, X:
Biomed Res Inst St Pau, Barcelona, Spain
De Antonio, M:
Biomed Res Inst St Pau, Barcelona, Spain
Villamor, JM:
Biomed Res Inst St Pau, Barcelona, Spain
Garcia, JA:
Biomed Res Inst St Pau, Barcelona, Spain
Ferre, MJ:
Biomed Res Inst St Pau, Barcelona, Spain
Popova, E:
Biomed Res Inst St Pau, Barcelona, Spain
Garutti, I:
Univ Gregorio Maranon, Gen Hosp, Madrid, Spain
Fernandez, C:
Univ Gregorio Maranon, Gen Hosp, Madrid, Spain
Palencia, M:
Univ Gregorio Maranon, Gen Hosp, Madrid, Spain
Diaz, S:
Univ Gregorio Maranon, Gen Hosp, Madrid, Spain
del Castillo, T:
Univ Gregorio Maranon, Gen Hosp, Madrid, Spain
Varela, A:
Univ Gregorio Maranon, Gen Hosp, Madrid, Spain
de Miguel, A:
Univ Gregorio Maranon, Gen Hosp, Madrid, Spain
Munoz, M:
Univ Gregorio Maranon, Gen Hosp, Madrid, Spain
Pineiro, P:
Univ Gregorio Maranon, Gen Hosp, Madrid, Spain
Cusati, G:
Univ Gregorio Maranon, Gen Hosp, Madrid, Spain
del Barrio, M:
Univ Gregorio Maranon, Gen Hosp, Madrid, Spain
Membrillo, MJ:
Univ Gregorio Maranon, Gen Hosp, Madrid, Spain
Orozco, D:
Univ Gregorio Maranon, Gen Hosp, Madrid, Spain
Reyes, F:
Univ Gregorio Maranon, Gen Hosp, Madrid, Spain
Sapsford, RJ:
Leeds Teaching Hosp, Leeds, W Yorkshire, England
Barth, J:
Leeds Teaching Hosp, Leeds, W Yorkshire, England
Scott, J:
Leeds Teaching Hosp, Leeds, W Yorkshire, England
Hall, A:
Leeds Teaching Hosp, Leeds, W Yorkshire, England
Howell, S:
Leeds Teaching Hosp, Leeds, W Yorkshire, England
Lobley, M:
Leeds Teaching Hosp, Leeds, W Yorkshire, England
Woods, J:
Leeds Teaching Hosp, Leeds, W Yorkshire, England
Howard, S:
Leeds Teaching Hosp, Leeds, W Yorkshire, England
Fletcher, J:
Leeds Teaching Hosp, Leeds, W Yorkshire, England
Dewhirst, N:
Leeds Teaching Hosp, Leeds, W Yorkshire, England
Williams, C:
Univ Liverpool, Inst Translat Med, Liverpool L69 3BX, Merseyside, England
Rushton, A:
Univ Liverpool, Inst Translat Med, Liverpool L69 3BX, Merseyside, England
Welters, I:
Univ Liverpool, Inst Translat Med, Liverpool L69 3BX, Merseyside, England
Leuwer, M:
Univ Liverpool, Inst Translat Med, Liverpool L69 3BX, Merseyside, England
Pearse, R:
Barts & London Queen Marys Sch Med & Dent, London, England
Royal London Hosp, London, England
Ackland, G:
UCL, London, England
Khan, A:
UCL, London, England
Niebrzegowska, E:
Royal London Hosp, London, England
Benton, S:
Royal London Hosp, London, England
Wragg, A:
Royal London Hosp, London, England
Archbold, A:
Royal London Hosp, London, England
Smith, A:
Royal London Hosp, London, England
McAlees, E:
Royal London Hosp, London, England
Ramballi, C:
Royal London Hosp, London, England
MacDonald, N:
Royal London Hosp, London, England
Januszewska, M:
Royal London Hosp, London, England
Stephens, R:
Royal London Hosp, London, England
Reyes, A:
Royal London Hosp, London, England
GallegoParedes, L:
UCL, London, England
Sultan, P:
UCL, London, England
Cain, D:
UCL, London, England
Whittle, J:
UCL, London, England
del Arroyo, AG:
UCL, London, England
Sun, Z:
Cleveland Clin, Cleveland, OH 44106 USA
Finnegan, PS:
Cleveland Clin, Cleveland, OH 44106 USA
Egan, C:
Cleveland Clin, Cleveland, OH 44106 USA
Honar, H:
Cleveland Clin, Cleveland, OH 44106 USA
Shahinyan, A:
Cleveland Clin, Cleveland, OH 44106 USA
Panjasawatwong, K:
Cleveland Clin, Cleveland, OH 44106 USA
Fu, AY:
Cleveland Clin, Cleveland, OH 44106 USA
Wang, S:
Washington Univ, Sch Med, St Louis, MO USA
Reineks, E:
Washington Univ, Sch Med, St Louis, MO USA
Blood, J:
Washington Univ, Sch Med, St Louis, MO USA
Kalin, M:
Washington Univ, Sch Med, St Louis, MO USA
Gibson, D:
Washington Univ, Sch Med, St Louis, MO USA
Wildes, T:
Washington Univ, Sch Med, St Louis, MO USA
Green Published
|