The role of high-sensitive troponin measurement as a biomarker during the postoperative period for the detection of myocardial injury after non-cardiac surgery

Iddagoda, Mayura Thilanka

doi:10.1177/1750458920930993

Cited by 7 publications

(9 citation statements)

References 38 publications

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“…The detection limit of cTnT is 0.1–2 ng/mL and the normal range is 0–0.1 ng/mL. 9 The new-generation high-sensitivity cTnT (hs-cTnT) has been adopted in clinical practice since 2012. The detection limit of hs-cTnT is 0–10,000 ng/l and normal range is 0–14 ng/l.…”

Section: Methodsmentioning

confidence: 99%

Release Profile of Cardiac Troponin T and Risk Factors of Postoperative Myocardial Injury in Patients Undergoing CABG

Gu¹,

Shan²,

Liu³

et al. 2021

IJGM

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Background Cardiac troponin T (cTnT) is currently one of the important indicators for clinical diagnosis of myocardial injury, which is inevitable in cardiac surgery, especially coronary artery bypass grafting (CABG). Describing the release profile of cTnT and finding out the risk factors of postoperative myocardial injury (PMI) are of great significance. The purposes of this study are to explore the release profile of cTnT in patients undergoing CABG and to search for independent risk factors of PMI. Methods In this retrospective study, clinical data of CABG patients were collected. The cTnT was measured at 24 hours before and 6, 12, 24, 48, 72, 96 and 120 hours after operation separately. The release profiles and peak time of cTnT in total cohort and sub-cohorts were observed. Independent risk factors of PMI were explored via univariate and multivariate logistic regression analyses. Results In total, 2084 patients were enrolled, including 998 patients in a cTnT group and 1086 patients in a high-sensitive cTnT (hs-cTnT) group. PMI was recognized in 797 patients. In both groups, cTnT showed a trend of rising first and then falling within 120 hours after operation. The peak cTnT appeared within 12–24 hours after operation, while the peak hs-cTnT occurred mostly within 24–48 hours after operation. Univariate logistic analysis showed that body mass index (BMI), New York Heart Association (NYHA) classification, coronary artery disease (CAD) classification, cerebrovascular disease, left ventricular ejection fraction, number of diseased vessels, valvular disease, intra-aortic balloon pump (IABP) implantation, chronic obstructive pulmonary disease, pulmonary hypertension, previous percutaneous coronary intervention (PCI), BMI, bypass graft number, cardiopulmonary bypass, and preoperative cTnT were related risk factors. Multivariate logistic regression analysis showed that NYHA classification, CAD classification, valvular disease, IABP implantation, pulmonary hypertension, previous PCI, bypass graft number, cardiopulmonary bypass, and preoperative cTnT were independent risk factors of PMI. Conclusion NYHA classification, CAD classification, valvular disease, IABP implantation, pulmonary hypertension, previous PCI, bypass graft number, cardiopulmonary bypass, and preoperative cTnT are independent risk factors of PMI in patients undergoing CABG.

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Section: Methodsmentioning

confidence: 99%

Release Profile of Cardiac Troponin T and Risk Factors of Postoperative Myocardial Injury in Patients Undergoing CABG

Gu¹,

Shan²,

Liu³

et al. 2021

IJGM

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“…Therefore, a portable, fast, and inexpensive biosensor device for the detection of cardiovascular diseases is a highly necessary element to monitor the onset and progression of cardiovascular disease quickly and accurately [ 66 ]. Troponin contains a combination of three protein subunits (troponin T (Tnt, ~35 kDa), troponin I (Tni, ~30 kDa) and troponin C (Tnc, ~18 kDa)) [ 67 , 68 ]. The increased troponin levels in patients, along with other clinical features, are the best tool for the rapid diagnosis of MI.…”

Section: Electrochemical Aptasensors For Clinical Applicationmentioning

confidence: 99%

Electrochemical Aptasensors: Current Status and Future Perspectives

Abd-Ellatief

2021

Diagnostics

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This article reviews the progress of diversity of electrochemical aptasensor for target analytes detection. The immobilization strategies of aptamers on an electrode surface are addressed. The aptasensors are also introduced in compliance with the assay platforms. Many electrochemical aptasensors are nearly identical to conventional immunochemical approaches, sandwich and competition assays using electroactive signaling moieties. Others are “signal-on” and “sign-off” aptasensors credited to the target binding-induced conformational change of aptamers. Label-free aptasensors are also highlighted. Furthermore, the aptasensors applied for clinically important biomarkers are emphasized.

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“…Therefore, the aim of this study was to investigate the incidence of PMI and mortality in high-risk patients undergoing surgical treatment for PJI or FRI using a systematic PMI screening programme included in routine clinical practice. 18,20,21…”

Section: Introductionmentioning

confidence: 99%

Perioperative myocardial injury and mortality after revision surgery for orthopaedic device-related infection

Kvarda

Puelacher

Clauss

et al. 2022

The Bone & Joint Journal

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Aims Periprosthetic joint infections (PJIs) and fracture-related infections (FRIs) are associated with a significant risk of adverse events. However, there is a paucity of data on cardiac complications following revision surgery for PJI and FRI and how they impact overall mortality. Therefore, this study aimed to investigate the risk of perioperative myocardial injury (PMI) and mortality in this patient cohort. Methods We prospectively included consecutive patients at high cardiovascular risk (defined as age ≥ 45 years with pre-existing coronary, peripheral, or cerebrovascular artery disease, or any patient aged ≥ 65 years, plus a postoperative hospital stay of > 24 hours) undergoing septic or aseptic major orthopaedic surgery between July 2014 and October 2016. All patients received a systematic screening to reliably detect PMI, using serial measurements of high-sensitivity cardiac troponin T. All-cause mortality was assessed at one year. Multivariable logistic regression models were applied to compare incidence of PMI and mortality between patients undergoing septic revision surgery for PJI or FRI, and patients receiving aseptic major bone and joint surgery. Results In total, 911 consecutive patients were included. The overall perioperative myocardial injury (PMI) rate was 15.4% (n = 140). Septic revision surgery for PJI was associated with a significantly higher PMI rate (43.8% (14/32) vs 14.5% (57/393); p = 0.001) and one-year mortality rate (18.6% (6/32) vs 7.4% (29/393); p = 0.038) compared to aseptic revision or primary arthroplasty. The association with PMI persisted in multivariable analysis with an adjusted odds ratio (aOR) of 4.7 (95% confidence interval (CI) 2.1 to 10.7; p < 0.001), but was not statistically significant for one-year mortality (aOR 1.9 (95% CI 0.7 to 5.4; p = 0.240). PMI rate (15.2% (5/33) vs 14.1% (64/453)) and one-year mortality (15.2% (5/33) vs 9.1% (41/453)) after FRI revision surgery were comparable to aseptic long-bone fracture surgery. Conclusion Patients undergoing revision surgery for PJI were at a risk of PMI and death compared to those undergoing aseptic arthroplasty surgery. Screening for PMI and treatment in specialized multidisciplinary units should be considered in major bone and joint infections. Cite this article: Bone Joint J 2022;104-B(6):696–702.

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The role of high-sensitive troponin measurement as a biomarker during the postoperative period for the detection of myocardial injury after non-cardiac surgery

Cited by 7 publications

References 38 publications

Release Profile of Cardiac Troponin T and Risk Factors of Postoperative Myocardial Injury in Patients Undergoing CABG

Release Profile of Cardiac Troponin T and Risk Factors of Postoperative Myocardial Injury in Patients Undergoing CABG

Electrochemical Aptasensors: Current Status and Future Perspectives

Perioperative myocardial injury and mortality after revision surgery for orthopaedic device-related infection

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