Preoperative cardiac troponin below the 99th-percentile upper reference limit and 30-day mortality after noncardiac surgery
- Authors
- Park, J[Park, Jungchan]; Hyeon, CW[Hyeon, Cheol Won]; Lee, SH[Lee, Seung-Hwa]; Lee, SM[Lee, Sangmin Maria]; Yeo, J[Yeo, Junghyun]; Yang, K[Yang, Kwangmo]; Min, JJ[Min, Jeong Jin]; Lee, JH[Lee, Jong Hwan]; Yang, JH[Yang, Jeong Hoon]; Song, YB[Song, Young Bin]; Hahn, JY[Hahn, Joo-Yong]; Choi, SH[Choi, Seung-Hyuk]; Choi, JH[Choi, Jin-Ho]; Gwon, HC[Gwon, Hyeon-Cheol]
- Issue Date
- 12-Oct-2020
- Publisher
- NATURE RESEARCH
- Citation
- SCIENTIFIC REPORTS, v.10, no.1
- Indexed
- SCIE
SCOPUS
- Journal Title
- SCIENTIFIC REPORTS
- Volume
- 10
- Number
- 1
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/2852
- DOI
- 10.1038/s41598-020-72853-3
- ISSN
- 2045-2322
- Abstract
- Preoperative high-sensitivity cardiac troponin (hs-cTn) above the 99th-percentile upper reference limit ( URL) is associated with mortality after noncardiac surgery. This study aimed to evaluate whether preoperative hs- cTn concentrations above the lowest limit of detection (LOD) but below the 99th-percentile URL can predict mortality after noncardiac surgery.From January 2010 to April 2019, a total of 12,415 noncardiac surgical patients with preoperative hs-cTn I below the 99th-percentile URL were enrolled. The patients were divided into two groups according to preoperative hs-cTn I concentration: (1) [hs-cTn] below the LOD (6 ng/L), and (2) mildly elevated [hs-cTn] but below the 99th-percentile URL (40 ng/L). The primary outcome was 30-day mortality. Of the 12,415 patients enrolled, 7958 ( 64.1%) were in the LOD group whereas 4457 (35.9%) were in the mild elevation group. The incidence of 30-day mortality was significantly greater in the mild elevation group (2.1% vs. 4.0% hazard ratio [HR] 1.73; 95% confidence interval [CI] 1.39-2.16; p < 0.001) in the multivariate analyses. The propensity score matched analyses also produced a similar result (2.6% vs. 4.2% HR 1.61; 95% CI 1.26-2.07; p < 0.001). The threshold at which the risk of mortality increased corresponded to a preoperative hs-cTn I >= 12 ng/L. Patients with preoperative hs-cTn I above the LOD and below the 99th-percentile URL had greater 30-day mortality after noncardiac surgery.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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