Observational studies suggest at least 1 per cent of patients aged 45 years or older undergoing major noncardiac surgery, die within 30 days of surgery.
Until now, little has been known about the relationship between perioperative high-sensitivity troponin T (hsTnT) and 30-day mortality and myocardial injury after noncardiac surgery (MINS).
A new study of 21,842 patients undergoing noncardiac surgery has found that compared to patients with postoperative peak hsTnT less than 5ng/l, patients with levels of 20ng/l to less than 65ng/L had a 30-day mortality rate of 3 per cent. Concentrations of 65ng/l to less than 1,000ng/l were associated with a rate of 9.1 per cent; and those with hsTnT 1,000ng/L or higher had a rate of 29.6 per cent.
An absolute hsTnT change of 5ng/L or higher was associated with almost five-fold increased risk of 30-day mortality. hsTnT levels of over 20ng/l to less than 65ng/L with an absolute change of at least 5ng/L or hsTnT of 65ng/L or more, without ischaemic features, were associated with three-fold increased 30-day mortality.
Writing in JAMA , the authors said, given the common use of the assay globally, hsTnT could be useful as a predictor of 30-day mortality and a diagnostic criterion for MINS.