Author/Authors :
Lee، نويسنده , , Thomas H. and Thomas، نويسنده , , Eric J. and Ludwig، نويسنده , , Lynn E. and Sacks، نويسنده , , David B. and Johnson، نويسنده , , Paula A. and Donaldson، نويسنده , , Magruder C. and Cook، نويسنده , , E.Francis and Pedan، نويسنده , , Alex and Kuntz، نويسنده , , Karen M. and Goldman، نويسنده , , Lee، نويسنده ,
Abstract :
To assess the diagnostic performance of cardiac troponin T as a marker for myocardial injury in patients undergoing major noncardiac surgery, we prospectively collected preoperative and postoperative clinical data, including measurements for creatine kinase (CK), CKMB, and troponin T for 1,175 patients undergoing major noncardiac surgery. Acute myocardial infarction was diagnosed in 17 patients (1.4%) by a reviewer who was blinded to troponin T data and who used CK-MB and electrocardiographic criteria to define acute myocardial infarction. Other predischarge major cardiac complications were detected for another 17 patients. Troponin T elevations (>0.1 ng/ml) occurred in 87% of patients with and in 16% of patients without myocardial infarction. Among patients without myocardial infarction, troponin T was elevated in 62% of patients with and in 15% of patients without major cardiac complications. Receiver-operating characteristic analysis indicated that troponin T had a performance for the diagnosis of acute myocardial infarction similar to CK-MB, and a significantly better correlation with other major cardiac complications in patients without definitive infarction. Future research should seek to determine the significance of troponin T elevations in patients without complications.
