Key result
Elevated preoperative troponin levels predict adverse cardiovascular events and mortality in patients undergoing non-cardiac surgery.
Why the study?
Preoperative myocardial injury increases perioperative and long-term cardiovascular risk, but its definition remains unclear and detection through routine troponin monitoring is challenging.
Preoperative myocardial injury, detected by elevated troponin levels, is a significant predictor of perioperative cardiovascular risk in non-cardiac surgery and requires careful clinical management.
Preoperative myocardial injury signals elevated perioperative and long-term risk; leaves open standardized definition and management trials.
Non-cardiac surgical procedures present a significant circulatory stress and can potentially trigger cardiovascular events, such as myocardial infarction and heart failure. Myocardial injury before non-cardiac surgery is associated with an increased risk of mortality and major cardiovascular complications during perioperative period, as well as up to 5 years after non-cardiac surgery. While the definition of preoperative myocardial injury is not yet clear, it is generally understood as myocardial injury resulting from various causes of troponin elevation without acute coronary syndrome prior to surgery. Detecting preoperative myocardial injury through routine troponin monitoring is crucial for reducing perioperative risk, but it is also challenging. The aim of this review is to discuss the definition of preoperative myocardial injury, its pathophysiology, implications on clinical practice and decision-making for patients with elevated troponin levels before non-cardiac surgery.
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Chen et al. (2023) conducted a review in Myocardial injury before noncardiac surgery. Elevated preoperative troponin vs. Normal preoperative troponin was evaluated. Elevated preoperative troponin levels predict adverse cardiovascular events and mortality in patients undergoing non-cardiac surgery.
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