Incremental value of high-sensitive troponin T in addition to the revised cardiac index for peri-operative risk stratification in non-cardiac surgery
Key result
Elevated high-sensitive troponin T independently predicted the combined endpoint of death and cardiovascular events in patients undergoing non-cardiac surgery (HR 2.6; 95% CI 1.3-5.3; P=0.01).
Why the study?
Does pre-operative high-sensitive troponin T measurement improve risk prediction for in-hospital mortality and cardiovascular events in patients undergoing non-cardiac surgery?
Population
979 patients prior to non-cardiac surgery in an international multicentre observational study
Comparison
Pre-operative high-sensitive troponin T… vs Revised cardiac index
Design
Cohort
Follow-up
in-hospital
Authors
Discussion
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Member takes
Implication
hsTnT may aid pre-op risk stratification beyond RCRI; leaves open whether routine use improves outcomes pending RCTs.
Study Design
Type
Observational (n=979)
Multicenter
Yes
Structured PICO
Does pre-operative high-sensitive troponin T measurement improve risk prediction for in-hospital mortality and cardiovascular events in patients undergoing non-cardiac surgery?
P
Population
979 patients evaluated prior to non-cardiac surgery to assess peri-operative risk.
E
Exposure
Pre-operative high-sensitive troponin T (hsTnT) measurement
C
Comparator
Revised cardiac index
O
Outcome
In-hospital mortality and a composite of death, acute myocardial infarction, cardiac arrest, cardio-pulmonary resuscitation, and acute decompensated heart failurecomposite
Main Result
Hazard Ratio: 2.6 (95% CI 1.3–5.3)
p-value: p=0.01
Pre-operative high-sensitive troponin T provides strong prognostic information for peri-operative cardiovascular events and mortality, incremental to the revised cardiac index in non-cardiac surgery.
Cite This Study
Weber et al. (2012) conducted an observational in Prior to non-cardiac surgery (n=979). High-sensitive troponin T (hsTnT) vs. Normal hsTnT levels / revised cardiac index was evaluated on Combination of death, acute myocardial infarction, cardiac arrest, cardio-pulmonary resuscitation, and acute decompensated heart failure (HR 2.6, 95% CI 1.3-5.3, p=0.01). Elevated high-sensitive troponin T independently predicted the combined endpoint of death and cardiovascular events in patients undergoing non-cardiac surgery (HR 2.6; 95% CI 1.3-5.3; P=0.01).