Assessment of the prognostic value of preoperative high-sensitive troponin T for myocardial injury and long-term mortality for groups at high risk for cardiovascular events following noncardiac surgery: a retrospective cohort study
BackgroundFew studies explored the association between high-sensitive cardiac troponin T (hs-cTnT) and long-term mortality for patients after surgery. This study was conducted to assess the association of hs-cTnT with long-term mortality and to investigate the extent to which this association is med...
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| Format: | Article |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1135786/full |
| _version_ | 1797797643496194048 |
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| author | Yingchao Zhu Yaodan Bi Qian Yu Bin Liu |
| author_facet | Yingchao Zhu Yaodan Bi Qian Yu Bin Liu |
| author_sort | Yingchao Zhu |
| collection | DOAJ |
| description | BackgroundFew studies explored the association between high-sensitive cardiac troponin T (hs-cTnT) and long-term mortality for patients after surgery. This study was conducted to assess the association of hs-cTnT with long-term mortality and to investigate the extent to which this association is mediated via myocardial injury after noncardiac surgery (MINS).MethodsThis retrospective cohort study included all patients with hs-cTnT measurements who underwent non-cardiac surgery at Sichuan University West China Hospital. Data were collected from February 2018 and November 2020, with follow-up through February 2022. The primary outcome was all-cause mortality within 1 year. As secondary outcomes, MINS, length of hospital stay (LOS), and ICU admission were analyzed.ResultsThe cohort included 7,156 patients (4,299 [60.1%] men; 61.0 [49.0–71.0] years). Among 7,156 patients, there were 2,151 (30.05%) with elevated hs-cTnT(>14 ng/L). After more than 1 year of follow-up, more than 91.8% of mortality information was available. During one-year follow-up after surgery, there were 308 deaths (14.8%) with a preoperative hs-cTnT >14 ng/L, compared with 192 deaths (3.9%) with a preoperative hs-cTnT <=14 ng/L(adjusted hazard ratio [aHR] 1.93, 95% CI 1.58–2.36; p < 0.001). Elevated preoperative hs-cTnT was also associated with several other adverse outcomes (MINS: adjusted odds ratio [aOR] 3.01; 95% CI, 2.46–3.69; p < 0.001; LOS: aOR 1.48, 95%CI 1.34–1.641; p < 0.001; ICU admission: aOR 1.52, 95%CI 1.31–1.76; p < 0.001). MINS explained approximately 33.6% of the variance in mortality due to preoperative hs-cTnT levels.ConclusionPreoperative elevated hs-cTnT concentrations have a significant association with long-term mortality after noncardiac surgery, one-third of which may by accounted for by MINS. |
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| language | English |
| last_indexed | 2024-03-13T03:51:27Z |
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| spelling | doaj.art-0eee63a80840440389b1a7b211dab2352023-06-22T12:11:45ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-06-011010.3389/fmed.2023.11357861135786Assessment of the prognostic value of preoperative high-sensitive troponin T for myocardial injury and long-term mortality for groups at high risk for cardiovascular events following noncardiac surgery: a retrospective cohort studyYingchao Zhu0Yaodan Bi1Qian Yu2Bin Liu3Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Anesthesiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Anesthesiology, Public Health Clinical Center of Chengdu, Chengdu, Sichuan, ChinaDepartment of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaBackgroundFew studies explored the association between high-sensitive cardiac troponin T (hs-cTnT) and long-term mortality for patients after surgery. This study was conducted to assess the association of hs-cTnT with long-term mortality and to investigate the extent to which this association is mediated via myocardial injury after noncardiac surgery (MINS).MethodsThis retrospective cohort study included all patients with hs-cTnT measurements who underwent non-cardiac surgery at Sichuan University West China Hospital. Data were collected from February 2018 and November 2020, with follow-up through February 2022. The primary outcome was all-cause mortality within 1 year. As secondary outcomes, MINS, length of hospital stay (LOS), and ICU admission were analyzed.ResultsThe cohort included 7,156 patients (4,299 [60.1%] men; 61.0 [49.0–71.0] years). Among 7,156 patients, there were 2,151 (30.05%) with elevated hs-cTnT(>14 ng/L). After more than 1 year of follow-up, more than 91.8% of mortality information was available. During one-year follow-up after surgery, there were 308 deaths (14.8%) with a preoperative hs-cTnT >14 ng/L, compared with 192 deaths (3.9%) with a preoperative hs-cTnT <=14 ng/L(adjusted hazard ratio [aHR] 1.93, 95% CI 1.58–2.36; p < 0.001). Elevated preoperative hs-cTnT was also associated with several other adverse outcomes (MINS: adjusted odds ratio [aOR] 3.01; 95% CI, 2.46–3.69; p < 0.001; LOS: aOR 1.48, 95%CI 1.34–1.641; p < 0.001; ICU admission: aOR 1.52, 95%CI 1.31–1.76; p < 0.001). MINS explained approximately 33.6% of the variance in mortality due to preoperative hs-cTnT levels.ConclusionPreoperative elevated hs-cTnT concentrations have a significant association with long-term mortality after noncardiac surgery, one-third of which may by accounted for by MINS.https://www.frontiersin.org/articles/10.3389/fmed.2023.1135786/fullrisk assessmentserum biomarkerspreoperative myocardial injuryhigh-sensitivity cardiac troponinnon-cardiac surgerypostoperative outcomes |
| spellingShingle | Yingchao Zhu Yaodan Bi Qian Yu Bin Liu Assessment of the prognostic value of preoperative high-sensitive troponin T for myocardial injury and long-term mortality for groups at high risk for cardiovascular events following noncardiac surgery: a retrospective cohort study Frontiers in Medicine risk assessment serum biomarkers preoperative myocardial injury high-sensitivity cardiac troponin non-cardiac surgery postoperative outcomes |
| title | Assessment of the prognostic value of preoperative high-sensitive troponin T for myocardial injury and long-term mortality for groups at high risk for cardiovascular events following noncardiac surgery: a retrospective cohort study |
| title_full | Assessment of the prognostic value of preoperative high-sensitive troponin T for myocardial injury and long-term mortality for groups at high risk for cardiovascular events following noncardiac surgery: a retrospective cohort study |
| title_fullStr | Assessment of the prognostic value of preoperative high-sensitive troponin T for myocardial injury and long-term mortality for groups at high risk for cardiovascular events following noncardiac surgery: a retrospective cohort study |
| title_full_unstemmed | Assessment of the prognostic value of preoperative high-sensitive troponin T for myocardial injury and long-term mortality for groups at high risk for cardiovascular events following noncardiac surgery: a retrospective cohort study |
| title_short | Assessment of the prognostic value of preoperative high-sensitive troponin T for myocardial injury and long-term mortality for groups at high risk for cardiovascular events following noncardiac surgery: a retrospective cohort study |
| title_sort | assessment of the prognostic value of preoperative high sensitive troponin t for myocardial injury and long term mortality for groups at high risk for cardiovascular events following noncardiac surgery a retrospective cohort study |
| topic | risk assessment serum biomarkers preoperative myocardial injury high-sensitivity cardiac troponin non-cardiac surgery postoperative outcomes |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1135786/full |
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