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Evaluation of perioperative high-sensitive cardiac troponin i as a predictive biomarker of major adverse cardiovascular events after noncardiac surgery
Millán-Figueroa, Alejandro; López-Navarro, Juan M.; Pérez-Díaz, Iván; Galindo-Uribe, Jaime; García-Martínez, Blanca; Villar-Velasco, Sonia L. Del; López-Gómez, Tomás; Zavaleta-Martínez, Zamar; Valladares-Pérez, Eduardo J.; Osorio-Landa, Hillary K.; Nieto-Niño, Andrea G.; Fernández-Pellón García, Rodrigo F.; Fagundo-Sierra, Reynerio.
  • Millán-Figueroa, Alejandro; Instituto Tecnológico y de Estudios Superiores de Monterrey. Department of Internal Medicine. Mexico City. MX
  • López-Navarro, Juan M.; Instituto Tecnológico y de Estudios Superiores de Monterrey. Department of Internal Medicine. Mexico City. MX
  • Pérez-Díaz, Iván; Instituto Tecnológico y de Estudios Superiores de Monterrey. Department of Internal Medicine. Mexico City. MX
  • Galindo-Uribe, Jaime; Secretaría de Salud. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Department of Cardiology. Mexico City. MX
  • García-Martínez, Blanca; Instituto Tecnológico y de Estudios Superiores de Monterrey. Department of Internal Medicine. Mexico City. MX
  • Villar-Velasco, Sonia L. Del; Secretaría de Salud. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Central Laboratory. Mexico City. MX
  • López-Gómez, Tomás; Secretaría de Salud. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Central Laboratory. Mexico City. MX
  • Zavaleta-Martínez, Zamar; Secretaría de Salud. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Department of Cardiology. Mexico City. MX
  • Valladares-Pérez, Eduardo J.; Instituto Tecnológico y de Estudios Superiores de Monterrey. Department of Internal Medicine. Mexico City. MX
  • Osorio-Landa, Hillary K.; Instituto Tecnológico y de Estudios Superiores de Monterrey. Department of Internal Medicine. Mexico City. MX
  • Nieto-Niño, Andrea G.; Secretaría de Salud. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Department of Cardiology. Mexico City. MX
  • Fernández-Pellón García, Rodrigo F.; Secretaría de Salud. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Department of Cardiology. Mexico City. MX
  • Fagundo-Sierra, Reynerio; Secretaría de Salud. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Central Laboratory. Mexico City. MX
Rev. invest. clín ; 72(2): 110-118, Mar.-Apr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1251842
ABSTRACT
ABSTRACT

Background:

Various studies suggest that perioperative concentrations of high-sensitivity troponins are incremental and predictive factors of a major adverse cardiac event (MACE) and all-cause mortality.

Objective:

The objective of the study was to evaluate the predictive value of high-sensitivity cardiac troponin I (hs-cTnI) in the development of MACE and all-cause mortality, within 30-days and 1-year follow-up after noncardiac surgery.

Methods:

In this prospective cohort study, we included men ≥ 45 years and women ≥ 55 years with ≥ 2 cardiovascular risk factors and undergoing intermediate or high-risk noncardiac surgery. Demographic and clinical information was collected from clinical charts. We measured baseline hs-cTnI 24 h before surgery, and its post-operative concentration 24 h after surgery.

Results:

In the entire sample, 8 patients (8.6%) developed MACE at 30-days follow-up (4 deaths), 12 (12.9%) within the 1st year (7 deaths), and 17 (18.2%) after complete post-surgical follow-up (10 deaths). We observed higher baseline and post-operative concentrations in patients who presented MACE (12 pg/ml vs. 3.5 pg/ml; p = 0.001 and 18.3 pg/ml vs. 5.45 pg/ml; p = 0.009, respectively). The hazard ratios (HRs) calculated by Cox regression analysis between the hs-cTnI baseline concentration and the post-operative development of MACE at 30-days and 1-year were 5.70 (95% confidence interval [CI], 1.10-29.40) with hs-cTnI > 6.2 pg/ml and 12.86 (95% CI, 1.42-116.34) with hs-cTnI > 3.3 pg/ml, respectively. The estimated post-operative HR death risk at 1-year was 14.43 (95% CI, 1.37-151.61) with hs-cTnI > 4.5 pg/ml.

Conclusions:

Pre-operative hs-cTnI was an independent predictive risk factor for MACE at 30-days and 1-year after noncardiac surgery and for all-cause mortality at 1-year after noncardiac surgery.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Postoperative Complications / Surgical Procedures, Operative / Cardiovascular Diseases / Troponin I Type of study: Diagnostic study / Observational study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male Language: English Journal: Rev. invest. clín Journal subject: Medicine Year: 2020 Type: Article Affiliation country: Mexico Institution/Affiliation country: Instituto Tecnológico y de Estudios Superiores de Monterrey/MX / Secretaría de Salud/MX

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Full text: Available Index: LILACS (Americas) Main subject: Postoperative Complications / Surgical Procedures, Operative / Cardiovascular Diseases / Troponin I Type of study: Diagnostic study / Observational study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male Language: English Journal: Rev. invest. clín Journal subject: Medicine Year: 2020 Type: Article Affiliation country: Mexico Institution/Affiliation country: Instituto Tecnológico y de Estudios Superiores de Monterrey/MX / Secretaría de Salud/MX