Perioperative troponin surveillance in major noncardiac surgery: a narrative review

被引：17

作者：

Chew, Michelle S. ^{[1
,2
,3
]}

Saugel, Bernd ^{[4
,5
]}

Lurati-Buse, Giovanna ^{[6
]}

机构：

[1] Linkoping Univ, Dept Anaesthes & Intens Care, Linkoping, Sweden

[2] Linkoping Univ, Dept Biomed, Linkoping, Sweden

[3] Linkoping Univ, Dept Clin Sci, Linkoping, Sweden

[4] Univ Med Ctr Hamburg Eppendorf, Ctr Anesthesiol & Intens Care Med, Dept Anesthesiol, Hamburg, Germany

[5] Outcomes Res Consortium, Cleveland, OH USA

[6] Univ Hosp Dusseldorf, Dept Anaesthesiol, Dusseldorf, Germany

来源：

BRITISH JOURNAL OF ANAESTHESIA | 2023年 / 130卷 / 01期

基金：

瑞典研究理事会; 欧盟地平线“2020”;

关键词：

biomarker; cardiac troponins; MINS; myocardial injury; noncardiac surgery; perioperative outcome; MYOCARDIAL INJURY; PREOPERATIVE ANEMIA; SHORT-TERM; MORTALITY; COMPLICATIONS; ASSOCIATION; MULTICENTER; PREDICTION; MANAGEMENT; ELEVATION;

D O I：

10.1016/j.bja.2022.08.041

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Myocardial injury is now an acknowledged complication in patients undergoing noncardiac surgery. Heterogeneity in the definitions of myocardial injury contributes to difficulty in evaluating the value of cardiac troponins (cTns) measurement in perioperative care. Pre-, post-, and peri-operatively increased cTns are encompassed by the umbrella term 'myocardial injury' and are likely to reflect different pathophysiological mechanisms. Increased cTns are independently associated with cardiovascular and non-cardiovascular complications, poor short-term and long-term cardiovascular outcomes, and increased mortality. Preoperative measurement of cTns aids preoperative risk stratification beyond the Revised Cardiac Risk Index. Systematic measurement detects acute perioperative increases and allows early identification of acute myocardial injury. Common definitions and standards for reporting are a prerequisite for designing impactful future trials and perioperative management strategies.

引用

页码：21 / 28

页数：8

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