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Perioperative troponin surveillance in major noncardiac surgery: a narrative review
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- Chew, Michelle (author)
- Linköpings universitet,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Region Östergötland, ANOPIVA US
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- Saugel, Bernd (author)
- Univ Med Ctr Hamburg Eppendorf, Germany; Outcomes Res Consortium, OH USA
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- Lurati-Buse, Giovanna (author)
- Univ Hosp Dusseldorf, Germany
- (creator_code:org_t)
- ELSEVIER SCI LTD, 2023
- 2023
- English.
- In: British Journal of Anaesthesia. - : ELSEVIER SCI LTD. - 0007-0912 .- 1471-6771. ; 130:1, s. 21-28
- Research review (peer-reviewed)
Abstract
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- Myocardial injury is now an acknowledged complication in patients undergoing noncardiac surgery. Heterogeneity in the definitions of myocardial injury contributes to difficulty in evaluating the value of cardiac troponins (cTns) measurement in perioperative care. Pre-, post-, and peri-operatively increased cTns are encompassed by the umbrella term myocardial injury and are likely to reflect different pathophysiological mechanisms. Increased cTns are independently associated with cardiovascular and non-cardiovascular complications, poor short-term and long-term cardiovascular outcomes, and increased mortality. Preoperative measurement of cTns aids preoperative risk stratification beyond the Revised Cardiac Risk Index. Systematic measurement detects acute perioperative increases and allows early identification of acute myocardial injury. Common definitions and standards for reporting are a prerequisite for designing impactful future trials and perioperative management strategies.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- biomarker; cardiac troponins; MINS; myocardial injury; noncardiac surgery; perioperative outcome
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