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  • Meister, RebeccaUniv Basel, Switzerland (author)

Prediction of perioperative myocardial infarction/injury in high-risk patients after noncardiac surgery

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • OXFORD UNIV PRESS,2023
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:liu-202379
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-202379URI
  • https://doi.org/10.1093/ehjacc/zuad090DOI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding Agencies|Swiss National Science Foundation; University Basel; Universitatsspital Basel; Swiss Heart Foundation; Roche Diagnostics; Abbott; Astra Zeneca Schweiz; Cardiovascular Research Foundation Basel; Fundacao de Amparo a Pesquisa do Estado de Sao Paulo, Brazil (FAPESP) [2015/23731-6]
  • Aims Perioperative myocardial infarction/injury (PMI) is a surprisingly common yet difficult-to-predict cardiac complication in patients undergoing noncardiac surgery. We aimed to assess the incremental value of preoperative cardiac troponin (cTn) concentration in the prediction of PMI. Methods and results Among prospectively recruited patients at high cardiovascular risk (age >= 65 years or >= 45 years with preexisting cardiovascular disease), PMI was defined as an absolute increase in high-sensitivity cTnT (hs-cTnT) concentration of >= 14 ng/L (the 99th percentile) above the preoperative concentration. Perioperative myocardial infarction/injury was centrally adjudicated by two independent cardiologists using serial measurements of hs-cTnT. Using logistic regression, three models were derived: Model 1 including patient- and procedure-related information, Model 2 adding routinely available laboratory values, and Model 3 further adding preoperative hs-cTnT concentration. Models were also compared vs. preoperative hs-cTnT alone. The findings were validated in two independent cohorts. Among 6944 patients, PMI occurred in 1058 patients (15.2%). The predictive accuracy as quantified by the area under the receiver operating characteristic curve was 0.73 [95% confidence interval (CI) 0.71-0.74] for Model 1, 0.75 (95% CI 0.74-0.77) for Model 2, 0.79 (95% CI 0.77-0.80) for Model 3, and 0.74 for hs-cTnT alone. Model 3 included 10 preoperative variables: age, body mass index, known coronary artery disease, metabolic equivalent >4, risk of surgery, emergency surgery, planned duration of surgery, haemoglobin, platelet count, and hs-cTnT. These findings were confirmed in both independent validation cohorts (n = 722 and n = 966). Conclusion Preoperative cTn adds incremental value above patient- and procedure-related variables as well as routine laboratory variables in the prediction of PMI.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Puelacher, ChristianUniv Basel, Switzerland (author)
  • Glarner, NoemiUniv Basel, Switzerland (author)
  • Gualandro, Danielle MenosiUniv Basel, Switzerland; Univ Sao Paulo, Brazil (author)
  • Andersson, HenrikLinköpings universitet,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Region Östergötland, ANOPIVA US(Swepub:liu)henan81 (author)
  • Pargger, MirjamUniv Basel, Switzerland (author)
  • Hure, GabrielleUniv Basel, Switzerland (author)
  • Virant, GeorgianaUniv Basel, Switzerland (author)
  • Bolliger, DanielUniv Basel, Switzerland (author)
  • Lampart, AndreasUniv Basel, Switzerland (author)
  • Steiner, LuziusUniv Basel, Switzerland (author)
  • Hidvegi, RekaUniv Basel, Switzerland; Cantonal Hosp St Gallen, Switzerland (author)
  • Buse, Giovanna LuratiUniv Hosp Dusseldorf, Germany (author)
  • Kindler, ChristophCantonal Hosp Aarau, Switzerland (author)
  • Gurke, LorenzUniv Basel, Switzerland (author)
  • Mujagic, EdinUniv Basel, Switzerland (author)
  • Schaeren, StefanUniv Basel, Switzerland (author)
  • Clauss, MartinUniv Basel, Switzerland (author)
  • Lardinois, DidierUniv Basel, Switzerland (author)
  • Hammerer-Lercher, AngelikaCantonal Hosp Aarau, Switzerland (author)
  • Chew, MichelleLinköpings universitet,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Region Östergötland, ANOPIVA US(Swepub:liu)micch61 (author)
  • Mueller, ChristianUniv Basel, Switzerland (author)
  • Univ Basel, SwitzerlandUniv Basel, Switzerland; Univ Sao Paulo, Brazil (creator_code:org_t)

Related titles

  • In:European Heart Journal: OXFORD UNIV PRESS12:11, s. 729-7392048-87262048-8734

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