title: Troponin-I Level After Major Noncardiac Surgery and Its Association With Long-Term Mortality.
abstract: Individuals with intermediate to high cardiac risk for major noncardiac surgery suffer from perioperative myocardial ischemic injury. The purpose of this study was to evaluate the long-term impact of postoperative cardiac troponin elevation on clinical outcome after major noncardiac surgery.Patients (n = 750) aged ≥ 50 years who underwent major noncardiac surgery were eligible for the study. Postoperative cardiac troponin-I data were collected retrospectively and consecutively. The primary outcome measure was allcause mortality. The median follow-up period was 1727 days in all patients.Among 750 patients, 92 (12.2%) showed elevated postoperative troponin-I above 0.10 ng/mL. Operative mortality was 4.1% (31 subjects), and patients with troponin-I elevation showed a higher operative mortality rate (RR: 4.23, 95% CI: 2.67-11.31, P < 0.001). In multivariate Cox regression analysis, a troponin-I concentration above 0.10 ng/mL was associated with all-cause mortality (RR: 1.73, 95% CI: 1.27-2.36, P < 0.001). It should be noted that there was a significant difference between patients with elevated and non-elevated troponin-I in the rate of mortality until 6 months. However, these differences disappeared after 6 months.An elevated troponin-I level conferred an increase in mortality during the 7 year follow-up period after major noncardiac surgery. This difference in mortality was mainly derived from the result within the first 6 months.
authors.affiliation: Regional Cardiocerebrovascular Center, Dong-A University Hospital.
authors.forename: Minkwan
authors.initials: M
authors.lastname: Kim
authors.forename: Minkook
authors.initials: M
authors.lastname: Son
authors.forename: Dong Hyun
authors.initials: DH
authors.lastname: Lee
authors.forename: Kyungil
authors.initials: K
authors.lastname: Park
authors.forename: Tae-Ho
authors.initials: TH
authors.lastname: Park
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000069451:Long Term Adverse Effects / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000209:etiology; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000097:blood*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D056910:Republic of Korea / Q000453:epidemiology; D013514:Surgical Procedures, Operative / Q000009:adverse effects* / Q000706:statistics & numerical data; D013997:Time Factors; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D019210:Troponin I