Why the study?
Clinical implementation of recommended peri-operative myocardial injury screening remains tentative due to a lack of local implementation examples, guidance on whom to screen, and consensus on assays and cTn cut-off values.
This expert consensus provides practical guidance on implementing peri-operative myocardial injury screening using cardiac troponin in noncardiac surgery.
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Enables troponin screening implementation for perioperative myocardial injury in noncardiac surgery; extends literature into structured clinical pathways.
Peri-operative myocardial injury, detected by dynamic and elevated cardiac troponin (cTn) concentrations, is a common complication of noncardiac surgery that is strongly associated with 30-day mortality. Although active screening for peri-operative myocardial injury has been suggested in recent guidelines, clinical implementation remains tentative due to a lack of examples on how to tackle such an interdisciplinary project at a local level. Moreover, consensus on which assay and cTn cut-off values should be used has not yet been reached, and guidance on whom to screen is lacking. In this article, we aim to summarise local examples of successfully implemented cTn screening practices and review the current literature in order to provide information and suggestions for patient selection, organisation of a screening programme, caveats and a potential management pathway.
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Puelacher et al. (2021) conducted a review in Peri-operative myocardial injury in noncardiac surgery. Cardiac troponin screening was evaluated. This expert consensus reviews current literature and provides suggestions for patient selection, organization of a screening program, and management pathways for peri-operative myocardial injury.
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