The Relevance of Implementing the Systematic Screening of Perioperative Myocardial Injury in Noncardiac Surgery Patients
Popova, Ekaterine (Institut d'Investigació Biomèdica Sant Pau)
Paniagua, Pilar (Institut d'Investigació Biomèdica Sant Pau)
Alvarez-Garcia, Jesus (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Vives-Borrás, Miquel (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
González Osuna, Aránzazu (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
García Osuna, Álvaro (Institut d'Investigació Biomèdica Sant Pau)
Rivas-Lasarte, Mercedes (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Hermenegildo-Chavez, Gisela (Institut d'Investigació Biomèdica Sant Pau)
Diaz-Jover, Ruben (Institut d'Investigació Biomèdica Sant Pau)
Azparren Cabezón, Gonzalo (Institut d'Investigació Biomèdica Sant Pau)
Barceló Trias, Montserrat (Institut d'Investigació Biomèdica Sant Pau)
Moustafa, Abdel Hakim (Institut d'Investigació Biomèdica Sant Pau)
Aguilar-Lopez, Raul (Hospital Universitari Vall d'Hebron)
Ordóñez, J. (Jordi) 1952- (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Alonso-Coello, Pablo (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Date:	2023
Abstract:	Perioperative myocardial injury (PMI) is a common cardiac complication. Recent guidelines recommend its systematic screening using high-sensitivity cardiac troponin (hs-cTn). However, there is limited evidence of local screening programs. We conducted a prospective, single-center study aimed at assessing the feasibility and outcomes of implementing systematic PMI screening. Hs-cTn concentrations were measured before and after surgery. PMI was defined as a postoperative hs-cTnT of ≥14 ng/L, exceeding the preoperative value by 50%. All patients were followed-up during the hospitalization, at one month and one year after surgery. The primary outcome was the incidence of death and major cardiovascular and cerebrovascular events (MACCE). The secondary outcomes focused on the individual components of MACCE. We included two-thirds of all eligible high-risk patients and achieved almost complete compliance with follow-ups. The prevalence of PMI was 15. 7%, suggesting a higher presence of cardiovascular (CV) antecedents, increased perioperative CV complications, and higher preoperative hs-cTnT values. The all-cause death rate was 1. 7% in the first month, increasing up to 11. 2% at one year. The incidence of MACCE was 9. 5% and 8. 6% at the same time points. Given the observed elevated frequencies of PMI and MACCE, implementing systematic PMI screening is recommendable, particularly in patients with increased cardiovascular risk. However, it is important to acknowledge that achieving optimal screening implementation comes with various challenges and complexities.
Rights:	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, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	High sensitivity cardiac troponin T ; Noncardiac surgery ; Perioperative myocardial injury ; Screening
Published in:	Journal of clinical medicine, Vol. 12 Núm. 16 (august 2023) , p. 5371, ISSN 2077-0383

DOI: 10.3390/jcm12165371
PMID: 37629413

16 p, 1.2 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
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