Prognostic performance of preoperative cardiac troponin and perioperative changes in cardiac troponin for the prediction of major adverse cardiac events and mortality in noncardiac surgery: A systematic review and meta-analysis

Increased postoperative cardiac troponin (cTn) independently predicts short-term mortality. Previous studies suggest that preoperative cTn also predicts major adverse cardiovascular events (MACE) and mortality after noncardiac surgery. The value of preoperative and perioperative changes in cTn as a...

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Bibliographic Details
Published in:PloS one 2019-04, Vol.14 (4), p.e0215094
Main Authors: Humble, Caroline A S, Huang, Stephen, Jammer, Ib, Björk, Jonas, Chew, Michelle S
Format: Article
Language:English
Subjects:
Biomarkers - metabolism
Bivariate analysis
Calcium-binding protein
Cardiac and Cardiovascular Systems
Cardiovascular diseases
Care and treatment
Clinical Medicine
Health risk assessment
Heart
Heart diseases
Hospital patients
Humans
Kardiologi
Kirurgi
Klinisk medicin
Medical and Health Sciences
Medical prognosis
Medical research
Medicin och hälsovetenskap
Meta-analysis
Mortality
Musculoskeletal Diseases - metabolism
Musculoskeletal Diseases - mortality
Musculoskeletal Diseases - pathology
Musculoskeletal Diseases - surgery
Nervous System Diseases - metabolism
Nervous System Diseases - mortality
Nervous System Diseases - pathology
Nervous System Diseases - surgery
Patient outcomes
Patients
Perioperative Care - mortality
Preoperative Care - mortality
Prognosis
Risk Assessment
Sensitivity analysis
Studies
Surgery
Surgical instruments
Survival Rate
Systematic review
Troponin
Troponin I - metabolism
Urologic Diseases - metabolism
Urologic Diseases - mortality
Urologic Diseases - pathology
Urologic Diseases - surgery
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Summary:Increased postoperative cardiac troponin (cTn) independently predicts short-term mortality. Previous studies suggest that preoperative cTn also predicts major adverse cardiovascular events (MACE) and mortality after noncardiac surgery. The value of preoperative and perioperative changes in cTn as a prognostic tool for adverse outcomes has been sparsely investigated. A systematic review and meta-analysis of the prognostic value of cTns for adverse outcome was conducted. Adverse outcome was defined as short-term (in-hospital or 30 days) MACE and/or all-cause mortality, in adult patients undergoing noncardiac surgery. The study protocol (CRD42018094773) was registered with an international prospective register of systematic reviews (PROSPERO). Preoperative cTn was a predictor of short- (OR 4.3, 95% CI 2.9-6.5, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0215094