Postoperative Troponin Levels Predict 30-Day Mortality After Noncardiac Surgery

However, the clinical value of routine postoperative monitoring of troponin levels remains unclear.


To evaluate the association between troponin levels and 30-day mortality after noncardiac surgery, investigators analyzed data on 15,133 adults aged 45 or older (51.5% women) enrolled in the prospective, international VISION study between August 2007 and January 2011. Using the same assay at all sites, troponin T levels were measured postoperatively at 6 to 12 hours and on days 1, 2, and 3 after surgery. Thirty-day follow-up data were available for 99.7% of the patients, of whom approximately 25% were aged 75 or older.

Overall 30-day mortality was 1.9%, and urgent or emergency surgery was the strongest independent predictor of 30-day mortality. In multivariate analysis, peak troponin levels were independently associated with 30-day mortality at thresholds of 0.02, 0.03, and 0.30 ng/mL (see table). No interaction was found between preoperative glomerular filtration rate and troponin thresholds.


Citation(s):

The Vascular Events In Noncardiac Surgery Patients Cohort Evaluation (VISION) Study Investigators. Association between postoperative troponin levels and 30-day mortality among patients undergoing noncardiac surgery. JAMA 2012 Jun 6; 307:2295.