The Correlation of Level of Surgical Risk with High Sensitivity Cardiac Troponin in Non-Cardiac Surgical Patients

Background: Myocardial injury after non-cardiac surgery (MINS) is an important issue, directly related to the mortality rate within 30 days after surgery. High sensitivity cardiac troponin (HS troponin) is the preferred biomarker for diagnosing myocardial damage because it is the most sensitive and specific heart biomarker currently available, making it suitable for detecting MINS. The aim of this study is to analyse the relationship between changes in HS troponin levels and surgery-related risks in non-cardiac surgery patients as a marker of myocardial injury. Method: This study is an analytical observational cross sectional study that included all patients who underwent non-cardiac surgery in the Airlangga University Hospital. Samples were taken using the consecutive sampling method. HS troponin values were measured before surgery and 24 hours after surgery. The level of surgical risk was assessed based on the criteria from ESAIC-ESC 2022. Statistical analysis used Spearman's correlation. Results: This study consisted of 75 samples, 39 men and 36 women, with a median age of 54 years. The results showed that there was a significant positive correlation between HS troponin levels and the level of surgical risk both from preoperative, postoperative values and changes in HS troponin levels. Median value (interquartile range) HS troponin with low risk level preoperatively vs. postoperatively 1.2 ng/L (0.0) vs. 1.2 ng/L (0.0), median difference 0.0 ng/L (0.0), p < 0.001. Median HS troponin value with moderate risk level preoperatively vs. postoperatively 1.2 ng/L (0.0) vs. 1.2 ng/L (0.0), median difference 0.0 ng/L (1.6), p < 0.001. Median HS troponin value with high risk level preoperatively vs. postoperatively 1.7 ng/L (18.8) vs. 11.9 ng/L (27.6), median difference 5.3 ng/L (11.4), p < 0.001. Conclusion: There is a significant correlation between changes in HS troponin levels and the level of surgical risk and the presence of complications.