Value of Routine Troponin Measurement in Open Abdominal Aortic Aneurysm Repair

Area of Science:

• Cardiology
• Vascular Surgery
• Critical Care Medicine

Background:

• Cardiovascular complications are a significant cause of death after major vascular surgery.
• Troponin elevation is common post-noncardiac surgery but often doesn't indicate myocardial infarction (MI).
• Outcomes of troponin elevation after elective open abdominal aortic aneurysm repair (oAAA) require specific investigation.

Purpose of the Study:

• To evaluate the association between troponin elevation and perioperative/overall mortality in elective oAAA repair.
• To compare outcomes between patients with and without troponin elevation.
• To assess the impact of routine troponin surveillance on mortality.

Main Methods:

• Retrospective review of 319 consecutive elective oAAA patients (2014-2019).
• Stratification into routine troponin check (RC) and not routinely checked (NRC) groups.
• Comparison of demographic data, cardiac comorbidities, and 30-day/3-year outcomes (MI, death) between groups.

Main Results:

• Elevated troponin (ET) occurred in 16.5% of RC patients and 4.7% of NRC patients.
• Patients with ET had higher 30-day MI rates and increased 3-year overall mortality.
• Routine troponin assessment did not significantly decrease 3-year mortality.

Conclusions:

• Elevated troponin after oAAA repair is linked to worse short-term and long-term outcomes.
• Routine postoperative troponin monitoring did not improve 3-year survival in this patient cohort.
• Further research is needed to optimize cardiac risk management in oAAA repair.