Perioperative myocardial infarction in noncardiac surgery: the diagnostic and prognostic role of cardiac troponins.
Despite the number of technologies used, the diagnosis of perioperative myocardial infarction is still a challenge. Studies conducted in surgical series have demonstrated that cardiac troponins (cTns) have both a superior diagnostic sensitivity and specificity, compared with other traditional techniques, and an independent power to predict short- and long-term prognosis. Nevertheless, some points need to be clarified. They include the usefulness of cTns in patients with end-stage renal failure; the standardization of the cTns cut-off for the diagnosis of myocardial injury; the timing of postoperative blood samplings; the cost-effectiveness of a screening in asymptomatic patients; and the possible therapeutic strategies.
Lucreziotti
S
S
Divisione di Cardiologia, Dipartimento di Medicina, Chirurgia e Odontoiatria, Università degli Studi di Milano, Italy. lucre.sp@libero.it
Foroni
C
C
Fiorentini
C
C
D003362:Cost-Benefit Analysis; D003937:Diagnosis, Differential; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014336:Troponin / Q000097:blood*
D014336:Troponin