Post-Op hsTnT Linked to 30-Day Mortality After Noncardiac Sx
Increased risk of 30-day mortality for absolute high-sensitivity troponin T change of 5ng/L or higher
TUESDAY, April 25, 2017 (HealthDay News) -- Peak postoperative high-sensitivity troponin T (hsTnT) is associated with increased risk of 30-day mortality among patients undergoing noncardiac surgery, according to a study published online April 25 in the Journal of the American Medical Association.
P.J. Devereaux, M.D., Ph.D., from McMaster University in Ontario, Canada, and colleagues conducted a prospective cohort study involving 21,842 participants who underwent inpatient noncardiac surgery and had a postoperative hsTnT measurement.
The researchers found that peak postoperative hsTnT levels of 20 to less than 65 ng/L, 65 to less than 1,000 ng/L, and 1,000 ng/L or higher were associated with 30-day mortality rates of 3, 9.1, and 29.6 percent, respectively, compared with the reference group (peak hsTnT <5ng/L), with corresponding adjusted hazard ratios of 23.63, 70.34, and 227.01, respectively. Increased risk of 30-day mortality was seen with an absolute hsTnT change of 5 ng/L or higher (adjusted hazard ratio, 4.69). There was a correlation for elevated postoperative hsTnT (20 to <65 ng/L with an absolute change of ≥5 ng/L or hsTnT ≥65 ng/L) without an ischemic feature with 30-day mortality (adjusted hazard ratio, 3.2). Overall, 93.1 percent of the 3,904 patients with myocardial injury after noncardiac surgery did not experience an ischemic symptom.
"Among patients undergoing noncardiac surgery, peak postoperative hsTnT during the first three days after surgery was significantly associated with 30-day mortality," the authors write.
Several authors disclosed financial ties to the pharmaceutical and medical device industries.