Clinical use of ultrasensitive cardiac troponin I assay in intermediate- and high-risk surgery patients.

Abstract:

BACKGROUND:Cardiac troponin levels have been reported to add value in the detection of cardiovascular complications in noncardiac surgery. A sensitive cardiac troponin I (cTnI) assay could provide more accurate prognostic information. METHODS:This study prospectively enrolled 142 patients with at least one Revised Cardiac Risk Index risk factor who underwent noncardiac surgery. cTnI levels were measured postoperatively. Short-term cardiac outcome predictors were evaluated. RESULTS:cTnI elevation was observed in 47 patients, among whom 14 were diagnosed as having myocardial infarction (MI). After 30 days, 16 patients had major adverse cardiac events (MACE). Excluding patients with a final diagnosis of MI, predictors of cTnI elevation included dialysis, history of heart failure, transoperative major bleeding, and elevated levels of pre- and postoperative N-terminal pro-B-type natriuretic peptide (NT-proBNP). Maximal cTnI values showed the highest sensitivity (94%), specificity (75%), and overall accuracy (AUC 0.89; 95% CI 0.80-0.98) for postoperative MACE. Postoperative cTnI peak level (OR 9.4; 95% CI 2.3-39.2) and a preoperative NT-proBNP level ≥917 pg/mL (OR 3.47; 95% CI 1.05-11.6) were independent risk factors for MACE. CONCLUSIONS:cTnI was shown to be an independent prognostic factor for cardiac outcomes and should be considered as a component of perioperative risk assessment.

journal_name

Dis Markers

journal_title

Disease markers

authors

Borges FK,Furtado MV,Rossini AP,Bertoluci C,Gonzalez VL,Bertoldi EG,Pezzali LG,Machado DL,Grutcki DM,Rech LG,Magalhães M,Polanczyk CA

doi

10.1155/2013/169356

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

945-53

issue

6

eissn

0278-0240

issn

1875-8630

journal_volume

35

pub_type

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