ArticleArquivos brasileiros de cardiologia2024
Addition of High-Sensitivity Troponin to Perioperative Risk Assessment Improves the Predictive Ability of Death in Non-Cardiac Surgery Patients.
Article in Arquivos brasileiros de cardiologia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- High-Sensitivity Troponin in Non-Cardiac SurgeryReplyAddition of High-sensitivity Troponin to Perioperative Risk Assessment Improves the Predictive Ability of Death in Non-cardiac Surgery Patients.Arquivos brasileiros de cardiologia · 2024Article
- Using High-Sensitivity Troponin for Enhancing Risk Prediction after Non-Cardiac Surgery - Are We There Yet?Arquivos brasileiros de cardiologia · 2024Article
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10 authors.
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Abstract
backgroundRisk stratification is an important step in perioperative evaluation. However, the main risk scores do not incorporate biomarkers in their set of variables.
objectiveEvaluate the incremental power of troponin to the usual risk stratification.
methodsA total of 2,230 patients admitted to the intensive care unit after non-cardiac surgery were classified according to three types of risk: cardiovascular risk (CVR), Revised Cardiac Risk Index (RCRI); and inherent risk of surgery (IRS). The main outcome was all-cause mortality. Cox regression was used as well as c-statistics before and after addition of high-sensitivity troponin (at least one measurement up to three days after surgery). Finally, net reclassification index and integrated discrimination improvement were used to assess the incremental power of troponin for risk stratification. Significance level was set at 0.05.
resultsMean age of patients was 63.8 years and 55.6% were women. The prevalence of myocardial injury after non-cardiac surgery (MINS) was 9.4%. High CVR-patients had a higher occurrence of MINS (40.1 x 24.8%, p<0.001), as well as high IRS-patients (21.3 x 13.9%, p=0.004) and those with a RCRI≥3 (3.0 x 0.7%, p=0.009). Patients without MINS, regardless of the assessed risk, had similar mortality rate. The addition of troponin to the risk assessment improved the predictive ability of death at 30 days and at 1 year in all risk assessments.
conclusionThe prevalence of MINS is higher in the high-risk population. However, its prevalence in lower-risk population is not negligible and causes a higher risk of death. The addition of high-sensitivity troponin increased the predictive ability of risk assessment in all groups.
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