High-Sensitivity Cardiac Troponin I Thresholds to Identify Myocardial Injury After Noncardiac Surgery: A Cohort Study

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dc.coverageDOI: 10.1016/j.cjca.2023.01.008
dc.creatorDuceppe, Emmanuelle
dc.creatorBorges, Flavia K.
dc.creatorTiboni, Maria
dc.creatorPearse, Rupert
dc.creatorChan, Matthew T.V.
dc.creatorSrinathan, Sadeesh
dc.creatorKavsak, Peter A.
dc.creatorGarg, Amit X.
dc.creatorSessler, Daniel I.
dc.creatorSapsford, Robert
dc.creatorHeels-Ansdell, Diane
dc.creatorPettit, Shirley
dc.creatorVasquez, Javiera
dc.creatorMueller, Christian
dc.creatorWalsh, Micheal
dc.creatorSzczeklik, Wojciech
dc.creatorRodseth, Reitze
dc.creatorLalu, Manoj
dc.creatorThabane, Lehana
dc.creatorGuyatt, Gordon
dc.creatorDevereaux, P. J.
dc.date2023
dc.date.accessioned2025-11-18T19:52:29Z
dc.date.available2025-11-18T19:52:29Z
dc.description<p>Background: Myocardial injury after noncardiac surgery (MINS) is common and associated with short- and long-term major cardiovascular events. Diagnostic criteria for MINS using Abbott high-sensitivity cardiac troponin I (hs-cTnI) are unknown. Methods: We performed a prospective cohort study of adults who had in-patient noncardiac surgery and measured hs-cTnI (Abbott Laboratories) on postoperative serum samples collected up to postoperative day 3. The objective was to determine prognostically important hs-cTnI thresholds associated with major cardiac events and death at 30 days after noncardiac surgery. Using Cox proportional iterative analyses, we determined peak postoperative hs-cTnI thresholds associated with the occurrence of the 30-day composite of major cardiac events (ie, nonfatal myocardial infarction after 3 postoperative days, cardiac arrest, and congestive heart failure) and death. Results: Of 3953 included patients, 66 (1.7%) experienced the primary outcome at 30 days. Peak hs-cTnI values and associated incidence of major cardiac events and death were as follows: &lt; 60 ng/L: 1.0% (95% CI 0.7-1.3); 60 to &lt; 700 ng/L: 8.6% (5.6-13.0); and ≥ 700 ng/L: 27.3% (16.4-41.9). Compared with peak hs-cTnI &lt; 60 ng/L, adjusted hazard ratios were 7.54 (95% CI% 4.27-13.32) for hs-cTnI values of 60 to &lt; 700 ng/L and 26.87 (13.27-54.41) for values ≥ 700 ng/L. Conclusions: Hs-cTnI elevation within the first 3 days after noncardiac surgery independently predicts major cardiac events and death at 30 days. A postoperative hs-cTnI ≥ 60 ng/L was associated with a &gt; 7-fold increase in the risk of subsequent major cardiac events and mortality at 30 days.</p>eng
dc.identifierhttps://investigadores.uandes.cl/en/publications/4be6f4ed-8c57-4507-86e6-30a7ae996857
dc.identifier.urihttps://repositorio.uandes.cl/handle/uandes/57734
dc.languageeng
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.sourcevol.39 (2023) nr.3 p.311-318
dc.titleHigh-Sensitivity Cardiac Troponin I Thresholds to Identify Myocardial Injury After Noncardiac Surgery: A Cohort Studyeng
dc.typeArticleeng
dc.typeArtículospa
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