The clinical importance of high-sensitivity cardiac troponin measurements for risk prediction in non-cardiac surgery

围手术期 医学 肌钙蛋白 重症监护医学 心脏外科 内科学 生物标志物 风险评估 心脏病学 肌钙蛋白I 外科 心肌梗塞 生物化学 化学 计算机安全 计算机科学
作者
Sjur H. Tveit,Peder L. Myhre,Torbjørn Omland
出处
期刊:Expert Review of Molecular Diagnostics [Taylor & Francis]
卷期号:23 (6): 535-544 被引量:5
标识
DOI:10.1080/14737159.2023.2211267
摘要

The global healthcare burden associated with surgery is substantial, with many patients experiencing perioperative complications. Cardiac troponin I and T measured with high-sensitivity assays are cardiac specific biomarkers that associate closely with adverse outcomes in most patient populations. Perioperative physiological stress can induce troponin release from cardiomyocytes, a condition known as perioperative myocardial injury (PMI). PMI is associated with increased risk of poor short- and long-term outcomes, and current European guidelines recommend screening for PMI in at-risk individuals undergoing non-cardiac surgery.In this review we summarize current knowledge of the prognostic attributes of cardiac troponins, as well as the challenges associated with their application as biomarkers in the perioperative phase.Measurement of circulating levels of cardiac troponins identify individuals at increased risk of poor postoperative outcomes. Systematic screening of at-risk individuals undergoing non-cardiac surgery will result in a large proportion of patients in need of further diagnostic workup to establish the exact nature of their PMI. The lack of concrete evidence of clinical benefit and the increased cost associated with such a strategy is concerning and underscore the need for further research.

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