Key result
Elevated postoperative CK-MB and cardiac troponin independently predicted long-term mortality after major vascular surgery, with a 4.19-fold increase in mortality when both were elevated (p<0.001).
Why the study?
Cardiac troponin threshold levels signifying perioperative myocardial infarction and their long-term prognostic value after surgery were not yet determined.
Does postoperative elevation of cardiac troponin, CK-MB, or myocardial ischemia predict long-term mortality in patients undergoing major vascular surgery?
Population
447 consecutive patients undergoing 501 major vascular procedures
Comparison
Different cutoff levels of CK-MB, troponin, and ischemia duration
Design
Prospective cohort study
Authors
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Identifies postoperative myocardial injury as marker for heightened long-term risk after vascular surgery; leaves open efficacy of targeted preventive therapies.
Cohort (n=447)
Does postoperative elevation of cardiac troponin, CK-MB, or myocardial ischemia predict long-term mortality in patients undergoing major vascular surgery?
Effect estimate: HR 4.19
p-value: p=<0.001
Postoperative elevations in CK-MB and cardiac troponin, even at low thresholds, are independent and complementary predictors of long-term mortality after major vascular surgery.
Landesberg et al. (2003) conducted a cohort in Major vascular surgery (n=447). Elevated postoperative CK-MB and cardiac troponin vs. Normal levels was evaluated on Long-term mortality (HR 4.19, p=<0.001). Elevated postoperative CK-MB and cardiac troponin independently predicted long-term mortality after major vascular surgery, with a 4.19-fold increase in mortality when both were elevated (p<0.001).
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