Core Concepts
High-sensitivity cardiac troponin T levels predict 30-day mortality post cardiac surgery.
Abstract
TOPLINE:
Perioperative myocardial injury, indicated by high-sensitivity cardiac troponin T release, links to 30-day mortality post cardiac surgeries.
METHODOLOGY:
Retrospective study with 8292 patients showed high hs-cTnT levels associated with 30-day mortality.
Troponin levels used to assess myocardial injury in CABG, AVR, and other cardiac surgeries.
TAKEAWAY:
30-day mortality rates varied among surgery types.
High hs-cTnT levels increased the risk of death post-surgery.
Predictive hs-cTnT levels for mortality were significantly higher than current definitions.
IN PRACTICE:
Study suggests current definitions of peri-procedural myocardial injury are too conservative.
Authors recommend updating diagnostic criteria with high-sensitivity cardiac troponin data.
SOURCE:
Study led by Leo Pölzl, MD, published in the Journal of the American College of Cardiology.
LIMITATIONS:
Retrospective, single-center study with potential confounding and bias.
Thresholds for troponin values may have lower sensitivity.
Results may not apply to all non-CABG, non-AVR surgery patients.
DISCLOSURES:
Study authors report no relevant conflicts of interest.
Devereaux has received grants from various organizations.
Stats
"Death within 30 days occurred in 2.5% of the patients."
"The threshold hs-cTnT level for predicting 30-day mortality was 2385 ng/L for isolated CABG."
"The area under the curve of 0.586 for 5-year mortality."
Quotes
"These results provide important novel insights into the association of hs-cTnT with 30-day mortality."
"The current diagnostic criteria for perioperative myocardial infarction/injury need to be updated with these high-sensitivity cardiac troponin data."