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Review
. 2021 Jun 1;38(6):600-608.
doi: 10.1097/EJA.0000000000001486.

Expert consensus on peri-operative myocardial injury screening in noncardiac surgery: A literature review

Christian Puelacher  1 , Bernardo Bollen Pinto, Nicholas L Mills, Emmanuelle Duceppe, Ekaterine Popova, Andreas Duma, Peter Nagele, Torbjørn Omland, Angelika Hammerer-Lercher, Giovanna Lurati Buse
Affiliations
Review

Expert consensus on peri-operative myocardial injury screening in noncardiac surgery: A literature review

Christian Puelacher et al. Eur J Anaesthesiol. .

Abstract

Peri-operative myocardial injury, detected by dynamic and elevated cardiac troponin (cTn) concentrations, is a common complication of noncardiac surgery that is strongly associated with 30-day mortality. Although active screening for peri-operative myocardial injury has been suggested in recent guidelines, clinical implementation remains tentative due to a lack of examples on how to tackle such an interdisciplinary project at a local level. Moreover, consensus on which assay and cTn cut-off values should be used has not yet been reached, and guidance on whom to screen is lacking. In this article, we aim to summarise local examples of successfully implemented cTn screening practices and review the current literature in order to provide information and suggestions for patient selection, organisation of a screening programme, caveats and a potential management pathway.

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References

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    1. Devereaux PJ, Chan MT, et al. Vascular Events In Noncardiac Surgery Patients Cohort Evaluation Study I. Association between postoperative troponin levels and 30-day mortality among patients undergoing noncardiac surgery. JAMA 2012; 307:2295–2304.
    1. Vascular Events In Noncardiac Surgery Patients Cohort Evaluation Study I. Association between complications and death within 30 days after noncardiac surgery. CMAJ 2019; 191:E830–E837.
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