scholarly journals Long-term Prognostic Value of Asymptomatic Cardiac Troponin T Elevations in Patients After Major Vascular Surgery

2004 ◽  
Vol 28 (1) ◽  
pp. 59-66 ◽  
Author(s):  
M.D Kertai ◽  
E Boersma ◽  
J Klein ◽  
H van Urk ◽  
J.J Bax ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Cardiac Troponin ◽  
Prognostic Value ◽  
Troponin T ◽  
Cardiac Troponin T ◽  
Major Vascular Surgery

scholarly journals Repeated Measurements of Cardiac Troponin T and N-Terminal Pro-B-Type Natriuretic Peptide to Assess Long-Term Mortality Risk in Subjects with Osteoarthritis

Biomolecules ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 230
Author(s):  
Martin Rehm ◽  
Gisela Büchele ◽  
Rolf Erwin Brenner ◽  
Klaus-Peter Günther ◽  
Hermann Brenner ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Cardiac Troponin ◽  
Prognostic Value ◽  
Troponin T ◽  
Repeated Measurements ◽  
Cardiac Troponin T ◽  
One Year ◽  
Long Term Mortality

Osteoarthritis (OA) is associated with higher cardiovascular mortality risk. High-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are well-characterized prognostic cardiac markers. We aimed to describe the changes in biomarkers measured one year apart in a cohort of 347 subjects with OA who underwent hip or knee replacement surgery in 1995/1996 and to analyze the prognostic value of repeated measurements for long-term mortality. During a median follow-up of 19 years, 209 (60.2%) subjects died. Substantial changes in cardiac biomarkers, especially for NT-proBNP, and an independent prognostic value of NT-proBNP for long-term mortality were found for both baseline measurement concentration (hazard ratio (HR) 1.32, 95% confidence interval (CI) (1.13–1.55)) and follow-up measurement concentration (HR 1.39, 95% CI 1.18–1.64) (all HR per standard deviation increase after natural log-transformation). Baseline concentrations were correlated with follow-up concentrations of NT-proBNP and no longer showed prognostic value when included simultaneously in a single model (HR 1.08, 95% CI 0.86–1.37), whereas the estimate for the one-year measurement remained robust (HR 1.31, 95% CI 1.04–1.66). Therefore, no significant additional benefit of repeated NT-proBNP measurements was found in this cohort, facilitating the use of a single NT-proBNP measurement as a stable prognostic marker.

Abstract 14566: Mild Elevation in Cardiac Troponin T is Independently Associated With Long-Term Mortality After Intermediate or High-Risk Vascular Surgery

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Grant W Reed ◽  
Samuel Horr ◽  
Stephen G Ellis ◽  
A. Michael Lincoff ◽  
Steven E Nissen ◽  
...  
Keyword(s):  
High Risk ◽  
Vascular Surgery ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Risk Index ◽  
Cox Proportional Hazards ◽  
Adverse Outcomes ◽  
Cardiac Troponin T ◽  
Long Term Mortality

Introduction: Myocardial injury is a risk factor for adverse outcomes after non-cardiac surgery. However, the prevalence of cardiac troponin T (cTnT) sampling after vascular surgery in real-word practice has not been well studied. Further, whether mild perioperative cTnT elevation is associated with long-term mortality is not established. Methods: This was a retrospective study of 13,196 patients who underwent intermediate or high-risk vascular surgery at a single center from January 1, 2010 - May 1, 2015. Patients were assessed for cTnT sampling within 96 hours of surgery. Cumulative 3 year mortality was stratified by absence of cTnT sampling, a normal value of 0.10 ng/mL. Cox proportional hazards analysis was used to adjust mortality for Revised Cardiac Risk Index (RCRI) score and other patient characteristics. Results: Mean age was 66.2±14.4 years, and 5,357 (40.6%) were female. Troponin was sampled in 3,296 (25.0%) patients, and among those 747 (5.7%) were elevated (positive yield 22.7%). There were 1,858 (14.1%) deaths. On Kaplan-Meier analysis, all-cause mortality was greatest with elevated cTnT (p<0.0001, Figure - A) and was higher across degrees of cTnT elevation (p<0.0001, Figure - B). After adjusting for RCRI score, age, gender, and diabetes, degree of cTnT elevation remained independently associated with mortality (Table). Conclusions: The degree of cTnT elevation independently predicts long-term mortality after vascular surgery. Even mild elevations of cTnT above threshold are associated with heightened risk of mortality, which extends well beyond the acute post-operative period.

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