Effect of Routine Postoperative Troponin Measurements on One Year Cardiac Events and Death

Study Abstract

Substantial advances in treating diseases and improving patient quality of life result in an increasing number of elderly patients undergoing noncardiac surgery. Worldwide an estimated 200 million adults undergo noncardiac surgery annually. The leading cause of postoperative morbidity is a major cardiovascular event (i.e., cardiovascular (CV) death, nonfatal myocardial infarction (MI), nonfatal cardiac arrest, and nonfatal stroke). For patients undergoing noncardiac surgery uncertainty exists regarding: the current incidence of postoperative major CV events; whether post surgical troponin measurements predict mortality and major CV events in the first year following surgery; whether screening for troponin after surgery will help physicians to avoid missing those MIs; and whether early postoperative cardiology consultation in patients with an elevated troponin improves outcome. To address these issues, Dr. van Klei undertook a prospective cohort study (2011-2012) including 10,000 consecutive moderate to high risk noncardiac surgery patients over the age of 60 in three large-sized hospitals. The outcome among these patients was compared to the outcome in a comparable retrospective cohort (2010). Based on Dr. van Klei’s study, in the three hospitals he is working with, routine postoperative troponin measurements have become standard care by spring 2011. In addition, this project has resulted in several new studies for Dr. van Klei.