Cardiovascular Risk Assessment for Noncardiac Surgery: Are We Ready for Biomarkers?

Biomarkers aided perioperative cardiac assessment is a relatively new concept. Cardiac biomarkers with historical significance (aspartate transaminase, dehydrogenase, creatinine kinase and myoglobin) have paved the way for traditional biomarkers (cardiac troponin, C-reactive protein, lipoprotein). C...

Full description

Saved in:
Bibliographic Details
Published in:Journal of cardiothoracic and vascular anesthesia 2020-07, Vol.34 (7), p.1914-1924
Main Authors: Dhir, Shalini, Dhir, Achal
Format: Article
Language:English
Subjects:
Biomarkers
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - epidemiology
cardiovascular system
Heart Disease Risk Factors
heart failure
Humans
Natriuretic Peptide, Brain
Peptide Fragments
perioperative care
Prognosis
Risk Assessment
Risk Factors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Biomarkers aided perioperative cardiac assessment is a relatively new concept. Cardiac biomarkers with historical significance (aspartate transaminase, dehydrogenase, creatinine kinase and myoglobin) have paved the way for traditional biomarkers (cardiac troponin, C-reactive protein, lipoprotein). Contemporary biomarkers like natriuretic peptides (BNP and ProBNP) are validated risk markers in both acute and chronic cardiac diseases and are showing remarkable promise in predicting serious cardiovascular complications after non-cardiac surgery. This review is intended to provide a critical overview of traditional and contemporary biomarkers for perioperative cardiovascular assessment and management. This review also discusses the potential utility of newer biomarkers like galectin-3, sST-2, GDF-15, TNF-alpha, MiRNAs and many others that can predict inflammation, cardiac remodeling, injury and endogenous stress and need further investigations to establish their clinical utility. Though promising, biomarker led perioperative care is still in infancy and it has not been determined that it can improve clinical outcomes.
ISSN:1053-0770
1532-8422
DOI:10.1053/j.jvca.2019.10.014