Why the study?
Although postoperative troponin elevation is linked to increased morbidity and mortality, the clinical value and etiology-tailored utility of routine screening after noncardiac surgery remain controversial.
Should routine daily cardiac troponin measurement be performed for 48 to 72 hours after noncardiac surgery in high-risk patients?
Should routine daily cardiac troponin measurement be performed for 48 to 72 hours after noncardiac surgery in high-risk patients?
This pro-con debate highlights the controversy surrounding routine postoperative troponin screening, balancing its prognostic value against the lack of clear therapeutic interventions for elevated levels.
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Routine troponin screening utility remains limited without interventions; leaves open need for trials linking detection to improved outcomes.
Elevated troponin levels within 3 days of surgery, independent of the presence of symptoms, are strongly linked to increased risk of short- and long-term morbidity and mortality. However, the value of screening with troponin measurements is controversial. The Canadian Cardiovascular Society guidelines on perioperative cardiac risk assessment and management for patients who undergo noncardiac surgery recommends measuring daily troponin for 48 to 72 hours after surgery in high-risk patients. Nevertheless, others doubt this recommendation, in part because postoperative elevated levels of troponin describe very little in terms of disease or event-specific pathogenesis and etiology, and thus, tailoring an intervention remains a challenge. This Pro-Con debate offers evidence-based data to stimulate physician understanding of daily practice and its significance in this matter, and assist in determining whether to use (Pro) or not to use (Con) this surveillance.
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A 2022 study studied this question.
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