title: Cardiac biomarkers in the prediction of risk in the non-cardiac surgery setting.
abstract: B-Type natriuretic peptides and troponin measurements have potential in predicting risk in patients undergoing non-cardiac surgery. Using the American Heart Association framework for the evaluation of novel biomarkers, we review the current evidence supporting the peri-operative use of these two biomarkers. In patients having major non-cardiac surgery who are risk stratified using clinical risk scores, the measurement of natriuretic peptides and troponin, both before and after surgery, significantly improves risk stratification. However, only pre- and postoperative natriuretic peptide measurement and postoperative troponin measurement have shown clinical utility. It is now important for trials to be conducted to determine whether integrating pre- and postoperative natriuretic peptide and postoperative troponin measurement into clinical practice is able to improve clinical outcomes in patients undergoing non-cardiac surgery.
authors.affiliation: Perioperative Research Group, Department of Anaesthetics, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: B M
authors.initials: BM
authors.lastname: Biccard
authors.forename: P J
authors.initials: PJ
authors.lastname: Devereaux
authors.forename: R N
authors.initials: RN
authors.lastname: Rodseth
mesh_terms: D015415:Biomarkers / Q000097:blood; D006331:Heart Diseases / Q000097:blood*; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood*; D011184:Postoperative Period; D057234:Preoperative Period; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D013514:Surgical Procedures, Operative; D014336:Troponin / Q000097:blood*
chemical_list: D015415:Biomarkers; D014336:Troponin; D020097:Natriuretic Peptide, Brain