Postop HsTnT Tied With Increased Death Risk After Noncardiac Surgery
Elevated postoperative hsTnT without an ischemic feature was also associated with 30-day mortality.
(HealthDay News) — Peak postoperative high-sensitivity troponin T (hsTnT) is associated with increased risk of 30-day mortality among patients undergoing noncardiac surgery, according to a study published online in the Journal of the American Medical Association.
P.J. Devereaux, MD, PhD, from McMaster University in Ontario, Canada, and colleagues conducted a prospective cohort study involving 21,842 participants who underwent inpatient noncardiac surgery and had a postoperative hsTnT measurement.
The researchers found that peak postoperative hsTnT levels of 20 to less than 65 ng/L, 65 to less than 1000 ng/L, and 1000 ng/L or higher were associated with 30-day mortality rates of 3%, 9.1%, and 29.6% percent, respectively, compared with the reference group (peak hsTnT <5ng/L), with corresponding adjusted hazard ratios of 23.63, 70.34, and 227.01, respectively. Increased risk of 30-day mortality was seen with an absolute hsTnT change of 5 ng/L or higher (adjusted hazard ratio, 4.69). There was a correlation for elevated postoperative hsTnT (20 to <65 ng/L with an absolute change of ≥5 ng/L or hsTnT ≥65 ng/L) without an ischemic feature with 30-day mortality (adjusted hazard ratio, 3.2). Overall, 93.1% of the 3904 patients with myocardial injury after noncardiac surgery did not experience an ischemic symptom.
"Among patients undergoing noncardiac surgery, peak postoperative hsTnT during the first 3 days after surgery was significantly associated with 30-day mortality," the authors write.
Several authors disclosed financial ties to the pharmaceutical and medical device industries.
- Devereaux PJ, Biccard BM, Sigamani A, et al. Association of Postoperative High-Sensitivity Troponin Levels With Myocardial Injury and 30-Day Mortality Among Patients Undergoing Noncardiac Surgery. JAMA. 25 April 2017. doi: 10.1001/jama.2017.4360