Weber, Michael and Luchner, Andreas and Manfred, Seeberger and Mueller, Christian and Liebetrau, Christoph and Schlitt, Axel and Apostolovic, Svetlana and Jankovic, Radmilo and Bankovic, Dragic and Jovic, Marina and Mitrovic, Veselin and Nef, Holger and Mollmann, Helge and Hamm, Christian W. (2013) Incremental value of high-sensitive troponin T in addition to the revised cardiac index for peri-operative risk stratification in non-cardiac surgery. EUROPEAN HEART JOURNAL, 34 (11). pp. 853-862. ISSN 0195-668X,
Full text not available from this repository. (Request a copy)Abstract
We aimed to evaluate the incremental value of high-sensitive troponin T (hsTnT) for risk prediction prior to non-cardiac surgery in comparison with the established revised cardiac index. In this prospective, international multicentre observational study, 979 patients prior to non-cardiac surgery were enrolled. The endpoints were in-hospital mortality, the combination of death, acute myocardial infarction, cardiac arrest, cardio-pulmonary resuscitation, and acute decompensated heart failure. Twenty-five patients (2.6) deceased and 36 (3.7) of the patients experienced the combined endpoint. Cardiac markers were elevated in those patients who died when compared with survivors (hsTnT: 21 ng/L vs. 7 ng/L; P 0.001; NT-proBNP: 576 pg/mL vs. 166 pg/mL; P 0.001). Applying a cut-off for hsTnT of 14 ng/L and for NT-proBNP of 300 pg/mL, those patients with elevated hsTnT had a mortality of 6.9 vs. 1.2 (P 0.001) and with elevated NT-proBNP 4.8 vs. 1.4 (P 0.002). The highest AUC of the ROC curve was found for hsTnT as a predictor for mortality of 0.809. In a multivariate Cox regression analyses, hsTnT was the strongest independent predictor for the combined endpoint [HR 2.6 (95 CI: 1.35.3); P 0.01]. High-sensitive troponin T provides strong prognostic information in patients undergoing non-cardiac surgery incremental to the widely accepted revised cardiac index.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | BRAIN NATRIURETIC PEPTIDE; CORONARY-ARTERY-DISEASE; VASCULAR-SURGERY; MYOCARDIAL-INFARCTION; MORTALITY; HEART; VALIDATION; GUIDELINES; ASSAY; CARE; High-sensitive Troponin T; Cardiac risk; Non-cardiac surgery; NT-proBNP |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Apr 2020 11:53 |
| Last Modified: | 23 Apr 2020 11:53 |
| URI: | https://pred.uni-regensburg.de/id/eprint/17053 |
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