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Reducing perioperative cardiac morbidity and mortality: is this the right goal?

Emily K Gordon1, Lee A Fleisher

  • 1Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.

Current Opinion in Critical Care
|July 3, 2013
PubMed

Insights

Elevated troponin levels after noncardiac surgery indicate higher risks. Lower troponin elevations are now recognized as significant, aiding in identifying patients needing interventions to reduce mortality.

Area of Science:

  • Cardiology
  • Perioperative Medicine
  • Cardiac Biomarkers

Background:

  • Noncardiac surgery leads to significant annual mortality and perioperative cardiac events.
  • Accurate risk stratification is crucial due to the growing number of surgical procedures.
  • Perioperative myocardial ischemia/necrosis is a key concern in surgical patients.

Purpose of the Study:

  • To review the significance of troponin elevation after noncardiac surgery.
  • To highlight the importance of identifying patients at high risk for adverse cardiac events.
  • To discuss interventions for improving outcomes in at-risk surgical patients.

Main Methods:

  • Review of recent publications on troponin levels and outcomes after noncardiac surgery.
  • Analysis of the association between troponin elevation and perioperative morbidity/mortality.
  • Evaluation of the diagnostic threshold for pathological troponin elevation.

Main Results:

  • Increased troponin following noncardiac surgery is linked to higher perioperative morbidity and mortality.
  • The threshold for troponin elevation indicating increased risk is lower than previously thought.
  • Troponin levels can identify patients with elevated risk for adverse events post-surgery.

Conclusions:

  • Troponin elevation after noncardiac surgery can identify high-risk patients.
  • Early identification allows for targeted interventions to improve patient outcomes.
  • Interventions may reduce in-hospital, 30-day, and long-term mortality in at-risk patients.
Abstract

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