High-sensitivity Troponin I Predicts Major Cardiovascular Events after Non-Cardiac Surgery: A Vascular Events in Non-Cardiac Surgery Patients Cohort Evaluation (VISION) Substudy

Abstract Background Myocardial injury after non-cardiac surgery (MINS), based on measurement of troponin T, is associated with perioperative major adverse cardiovascular events (MACE). We therefore determined the high-sensitivity troponin I (hsTnI) thresholds associated with 30 day MACE after non-ca...

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Published in:Clinical chemistry (Baltimore, Md.) Md.), 2023-04, Vol.69 (5), p.492-499
Main Authors: Borges, Flavia K, Duceppe, Emmanuelle, Heels-Ansdell, Diane, Patel, Ameen, Sessler, Daniel I, Tandon, Vikas, Chan, Matthew, Pearse, Rupert, Srinathan, Sadeesh, Garg, Amit X, Sapsford, Robert J, Ofori, Sandra N, Marcucci, Maura, Kavsak, Peter A, Pettit, Shirley, Spence, Jessica, Belley-Cote, Emilie, McGillion, Michael, Whitlock, Richard, Lamy, Andre, Conen, David, Thomas, Sabu, Mueller, Christian, Jaffe, Allan S, Devereaux, P J
Format: Article
Language:English
Subjects:
Biomarkers
Cohort Studies
Heart Failure
Humans
Myocardial Infarction - diagnosis
Troponin I
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Summary:Abstract Background Myocardial injury after non-cardiac surgery (MINS), based on measurement of troponin T, is associated with perioperative major adverse cardiovascular events (MACE). We therefore determined the high-sensitivity troponin I (hsTnI) thresholds associated with 30 day MACE after non-cardiac surgery. Methods We performed a nested biobank cohort study of 4553 patients from the Vascular Events in Non-Cardiac Surgery Patients Cohort Evaluation (VISION) Study. We measured hsTnI (ADVIA Centaur® hsTnI assay) on postoperative days 1 to 3 in patients ≥45 years undergoing non-cardiac surgery. An iterative Cox proportional hazard model determined peak postoperative hsTnI thresholds independently associated with MACE (i.e., death, myocardial infarction occurring on postoperative day 4 or after, non-fatal cardiac arrest, or congestive heart failure) within 30 days after surgery. Results MACE occurred in 89/4545 (2.0%) patients. Peak hsTnI values of
ISSN:0009-9147
1530-8561
DOI:10.1093/clinchem/hvad005