Incidence and outcomes of perioperative myocardial infarction/injury diagnosed by high-sensitivity cardiac troponin I

• DOI: 10.1007/s00392-021-01827-w
• Publication Date: 2021-03-25T23:10:28Z
• Authors: Danielle M. Guala...; Christian Puelacher; Giovanna Lurati Buse; Noemi Glarner; Francisco A. Cardozo; Ronja Vogt; Reka Hidvegi; Celia Strunz; Daniel Bolliger; Johanna Gueckel; Pai C. Yu; Marcel Liffert; Ketina Arslani; Alexandra Prepoudis; Daniela Calderaro; Angelika Hammerer...; Andreas Lampart; Luzius A. Steiner; Stefan Schären; Christoph Kindler; Lorenz Guerke; Stefan Osswald; P. J. Devereaux; Bruno Caramelli; Christian Mueller; ; Stella Marbot; Ivo Strebel; Alessandro Genini; Katharina Rentsch; Jasper Boeddinghaus; Thomas Nestelberger; Karin Wild; Tobias Zimmermann; Alberto J. S. Duarte; Andreas Buser; Nelson de Luccia; Luca Koechlin; Desiree Wussler; Joan Walter; Velina Widmer; Michael Freese; Pedro Lopez-Ayala; Raphael Twerenbold; Patrick Badertscher; Esther Seeberger; Thomas Wolff; Edin Mujagic; Arne Mehrkens; Julia Dinort; Gregor Fahrni; Raban Jeger; Christoph Kaiser; Mariana Matheus; Adriana F. Pastana
• Keywords: Troponin T; Troponin complex

Abstract Background Perioperative myocardial infarction/injury (PMI) diagnosed by high-sensitivity troponin (hs-cTn) T is frequent and a prognostically important complication of non-cardiac surgery. We aimed to evaluate the incidence outcome PMI using hs-cTnI, compare it hs-cTnT. Methods prospectively included 2455 patients at high cardiovascular risk undergoing 3111 surgeries, for whom hs-cTnI hs-cTnT concentrations were measured before surgery on postoperative days 1 2. was defined as composite perioperative infarction (PMI Infarct ) injury Injury ), according Fourth Universal Definition Myocardial Infarction. All-cause mortality primary endpoint. Results Using overall 9% (95% confidence interval [CI] 8–10%), including 2.6% CI 2.0–3.2) 6.1% 5.3–6.9%), which lower versus hs-cTnT: 15% 14–16%), 3.7% 3.0–4.4) 11.3% 10.2–12.4%). occurred in 52 (2%) within 30 217 (9%) year. both independent predictors 30-day all-cause (adjusted hazard ratio [aHR] 2.5 [95% 1.1–6.0], aHR 2.8 1.4–5.5], respectively) and, 1-year (aHR 2.0 1.2–3.3], 1.8 1.2–2.7], respectively). Overall, prognostic impact comparable Conclusions less common remain mortality. Graphic abstract