Assessment of the Prognostic Value of Preoperative High-sensitive Troponin T for Myocardial Injury and Long-term Mortality for Groups at High Risk for Cardiovascular Events Following Noncardiac Surgery: a Retrospective Cohort Study

Overview

Journal Front Med (Lausanne)

Specialty General Medicine

Date 2023 Jul 10

PMID 37425305

Authors

Yingchao Zhu

Yaodan Bi

Qian Yu

Bin Liu

Affiliations

Soon will be listed here.

Abstract

Background: Few studies explored the association between high-sensitive cardiac troponin T (hs-cTnT) and long-term mortality for patients after surgery. This study was conducted to assess the association of hs-cTnT with long-term mortality and to investigate the extent to which this association is mediated via myocardial injury after noncardiac surgery (MINS).

Methods: This retrospective cohort study included all patients with hs-cTnT measurements who underwent non-cardiac surgery at Sichuan University West China Hospital. Data were collected from February 2018 and November 2020, with follow-up through February 2022. The primary outcome was all-cause mortality within 1 year. As secondary outcomes, MINS, length of hospital stay (LOS), and ICU admission were analyzed.

Results: The cohort included 7,156 patients (4,299 [60.1%] men; 61.0 [49.0-71.0] years). Among 7,156 patients, there were 2,151 (30.05%) with elevated hs-cTnT(>14 ng/L). After more than 1 year of follow-up, more than 91.8% of mortality information was available. During one-year follow-up after surgery, there were 308 deaths (14.8%) with a preoperative hs-cTnT >14 ng/L, compared with 192 deaths (3.9%) with a preoperative hs-cTnT <=14 ng/L(adjusted hazard ratio [aHR] 1.93, 95% CI 1.58-2.36; < 0.001). Elevated preoperative hs-cTnT was also associated with several other adverse outcomes (MINS: adjusted odds ratio [aOR] 3.01; 95% CI, 2.46-3.69; < 0.001; LOS: aOR 1.48, 95%CI 1.34-1.641; < 0.001; ICU admission: aOR 1.52, 95%CI 1.31-1.76; < 0.001). MINS explained approximately 33.6% of the variance in mortality due to preoperative hs-cTnT levels.

Conclusion: Preoperative elevated hs-cTnT concentrations have a significant association with long-term mortality after noncardiac surgery, one-third of which may by accounted for by MINS.

Citing Articles

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