Study protocol for an observational cohort evaluating incidence and clinical relevance of perioperative elevation of high-sensitivity troponin I and N-terminal pro-brain natriuretic peptide in patients undergoing lung resection
Alonso, María (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Popova, Ekaterine (Centro Cochrane Iberoamericano)
Martín-Grande, Ascensión (Hospital Universitario Ramón y Cajal (Madrid))
Pérez-Vélez, Javier (Hospital Universitari Vall d'Hebron)
Trujillo-Reyes, Juan Carlos (Institut d'Investigació Biomèdica Sant Pau)
Gajate, Luis (Hospital Universitario Ramón y Cajal (Madrid))
de Miguel, Marcos (Hospital Universitari Vall d'Hebron)
González-Tallada, Anna (Hospital Universitari Vall d'Hebron)
Martínez-Téllez, Elisabeth (Institut d'Investigació Biomèdica Sant Pau)
Cladellas-Gutierrez, Esther (Institut d'Investigació Biomèdica Sant Pau)
Planas, Georgina (Institut d'Investigació Biomèdica Sant Pau)
de Pablo, Angélica (Hospital Universitario Ramón y Cajal (Madrid))
Parise, Diego (Hospital Universitario Ramón y Cajal (Madrid))
Candela-Toha, Angel (Hospital Universitario Ramón y Cajal (Madrid))
Nadal Clanchet, Miriam de (Universitat Autònoma de Barcelona. Departament de Cirurgia)

Data:	2022
Resum:	INTRODUCTION: Myocardial injury after non-cardiac surgery has been defined as myocardial injury due to ischaemia, with or without additional symptoms or ECG changes occurring during or within 30 days after non-cardiac surgery and mainly diagnosed based on elevated postoperative cardiac troponin (cTn) values. In patients undergoing thoracic surgery for lung resection, only postoperative cTn elevations are seemingly not enough as an independent predictor of cardiovascular complications. After lung resection, troponin elevations may be regulated by mechanisms other than myocardial ischaemia. The combination of perioperative natriuretic peptide measurement together with high-sensitivity cTns may help to identify changes in ventricular function during thoracic surgery. Integrating both cardiac biomarkers may improve the predictive value for cardiovascular complications after lung resection. We designed our cohort study to evaluate perioperative elevation of both high-sensitivity troponin I (hs-TnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients undergoing lung resection and to establish a risk score for major cardiovascular postoperative complications. METHODS AND ANALYSIS: We will conduct a prospective, multicentre, observational cohort study, including 345 patients undergoing elective thoracic surgery for lung resection. Cardiac biomarkers such as hs-TnI and NT-proBNP will be measured preoperatively and at postoperatively on days 1 and 2. We will calculate a risk score for major cardiovascular postoperative complications based on both biomarkers' perioperative changes. All patients will be followed up for 30 days after surgery. ETHICS AND DISSEMINATION: All participating centres were approved by the Ethics Research Committee. Written informed consent is required for all patients before inclusion. Results will be disseminated through publication in peer-reviewed journals and presentations at national or international conference meetings. TRIAL REGISTRATION NUMBER: NCT04749212.
Ajuts:	Instituto de Salud Carlos III PI20/00154
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Myocardial infarction ; Preventive Medicine ; Thoracic surgery
Publicat a:	BMJ open, Vol. 12 Núm. 12 (august 2022) , p. e063778, ISSN 2044-6055

DOI: 10.1136/bmjopen-2022-063778
PMID: 36600389

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