The Library
Association of high-sensitivity cardiac troponin T with 30-day and 5-year mortality after cardiac surgery
Tools
(2023) Association of high-sensitivity cardiac troponin T with 30-day and 5-year mortality after cardiac surgery. Journal of the American College of Cardiology, 82 (13). pp. 1301-1312. doi:10.1016/j.jacc.2023.07.011 ISSN 0735-1097.
Research output not available from this repository.
Request-a-Copy directly from author or use local Library Get it For Me service.
Official URL: http://doi.org/10.1016/j.jacc.2023.07.011
Abstract
Background
The relevance of perioperative myocardial injury (PMI) after cardiac surgery for 30-day mortality and long-term survival remains to be determined.
Objectives
This study assessed the association of PMI after cardiac surgery, reflected by postoperative troponin release, with 30-day mortality and long-term survival after: 1) coronary artery bypass grafting (CABG); 2) isolated aortic valve replacement (AVR) surgery; and 3) all other cardiac surgeries.
Methods
A consecutive cohort of 8,292 patients undergoing cardiac surgery with serial perioperative high-sensitivity cardiac troponin T (hs-cTnT) measurements was retrospectively analyzed. The relationship between postoperative hs-cTnT release and 30-day mortality or 5-year mortality was analyzed after adjustment with EuroSCORE II using a Cox proportional hazards model. hs-cTnT thresholds for 30-day and 5-year mortality were determined for isolated CABG (32.3%), AVR (14%), and other cardiac surgery (53.8%).
Results
High postoperative hs-cTnT levels were associated with higher 30-day mortality but not 5-year mortality. In CABG, median peak concentration of postoperative hs-cTnT was 1,044 ng/L, in AVR it was 502 ng/L, and in other cardiac surgery it was 1,110 ng/L. hs-cTnT thresholds defining mortality-associated PMI were as follows: for CABG, 2,385 ng/L (170× the upper reference limit of normal in a seemingly healthy population [URL]); for AVR, 568 ng/L (41× URL); and for other cardiac procedures, 1,873 ng/L (134× URL). hs-cTnT levels above the cutoffs resulted in an HR for 30-day mortality for CABG of 12.56 (P < 0.001), for AVR of 4.44 (P = 0.004), and for other cardiac surgery of 3.97 (P < 0.001).
Conclusions
PMI reflected by perioperative hs-cTnT release is associated with the expected 30-day mortality but not 5-year mortality. Postoperative hs-cTnT cutoffs to identify survival-relevant PMI are higher than suggested in current definitions.
Item Type: | Journal Article | ||||||||
---|---|---|---|---|---|---|---|---|---|
Divisions: | Faculty of Science, Engineering and Medicine > Science > Statistics | ||||||||
SWORD Depositor: | Library Publications Router | ||||||||
Journal or Publication Title: | Journal of the American College of Cardiology | ||||||||
Publisher: | Elsevier Inc. | ||||||||
ISSN: | 0735-1097 | ||||||||
Official Date: | 26 September 2023 | ||||||||
Dates: |
|
||||||||
Volume: | 82 | ||||||||
Number: | 13 | ||||||||
Page Range: | pp. 1301-1312 | ||||||||
DOI: | 10.1016/j.jacc.2023.07.011 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Reuse Statement (publisher, data, author rights): | ** Article version: AM ** Embargo end date: 18-09-2024 ** From Elsevier via Jisc Publications Router ** History: accepted 05-07-2023; epub 18-09-2023; issued 26-09-2023. ** Licence for AM version of this article starting on 18-09-2024: http://creativecommons.org/licenses/by-nc-nd/4.0/ | ||||||||
Access rights to Published version: | Restricted or Subscription Access |
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |