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).
Observational (n=979)
Yes
Does pre-operative high-sensitive troponin T measurement improve risk prediction for in-hospital mortality and cardiovascular events in patients undergoing non-cardiac surgery?
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.
Hazard Ratio: 2.6 (95% CI 1.3–5.3)
p-value: p=0.01
AIMS: We aimed to evaluate the incremental value of high-sensitive troponin T (hsTnT) for risk prediction prior to non-cardiac surgery in comparison with the established revised cardiac index. METHODS AND RESULTS: In this prospective, international multicentre observational study, 979 patients prior to non-cardiac surgery were enrolled. The endpoints were in-hospital mortality, the combination of death, acute myocardial infarction, cardiac arrest, cardio-pulmonary resuscitation, and acute decompensated heart failure. Twenty-five patients (2.6%) deceased and 36 (3.7%) of the patients experienced the combined endpoint. Cardiac markers were elevated in those patients who died when compared with survivors (hsTnT: 21 ng/L vs. 7 ng/L; P < 0.001; NT-proBNP: 576 pg/mL vs. 166 pg/mL; P < 0.001). Applying a cut-off for hsTnT of 14 ng/L and for NT-proBNP of 300 pg/mL, those patients with elevated hsTnT had a mortality of 6.9 vs. 1.2% (P < 0.001) and with elevated NT-proBNP 4.8 vs. 1.4% (P = 0.002). The highest AUC of the ROC curve was found for hsTnT as a predictor for mortality of 0.809. In a multivariate Cox regression analyses, hsTnT was the strongest independent predictor for the combined endpoint HR 2.6 (95% CI: 1.3-5.3); P = 0.01. CONCLUSION: High-sensitive troponin T provides strong prognostic information in patients undergoing non-cardiac surgery incremental to the widely accepted revised cardiac index.
Weber et al. (Wed,) conducted a 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).