Monitoring postoperative troponin T measurements can enhance risk stratification after noncardiac surgery and help physicians identify which patients will require more intensive monitoring and management. The large international Vascular events In noncardiac Surgery patIents cOhort evaluatioN (VISION) Study by the McMaster University has shown the Elecsys Troponin T assay from Roche to improve prediction of 30-day mortality in patients following noncardiac surgery. Now published in The Journal of the American Medical Association (JAMA), these findings will help health professionals to assess the short-term risk to individual patients and tailor their monitoring, treatment and management accordingly to reduce the post-operative mortality risk.
Of the 200 million adults worldwide who undergo noncardiac surgery each year, more than 1 million die within 30 days. Current preoperative risk prediction models have a limited ability to predict mortality. The VISION team aimed at improving risk prediction utilizing the 4th-generation Elecsys Troponin T assay to measure troponin T (TnT) levels in patients after noncardiac surgery. The results revealed a correlation between higher peak TnT levels and increased 30-day mortality.
The release of the protein TnT occurs only after cardiac damage, but little is known about interpreting TnT levels in patients following noncardiac surgery.
The VISION Study used the 4th generation Elecsys Troponin T assay from Roche to accurately analyze blood samples from patients who had undergone noncardiac inpatient surgery. The team measured TnT levels in patients 6 to 12 hours after surgery and on days one, two, and three after surgery to determine if there was a link between peak TnT levels and 30-day mortality. The VISION Study demonstrates that measuring TnT levels in the first 3 days after noncardiac surgery substantially improves risk prediction and reduces the possibility of misdiagnosis or missed diagnosis of complications. Specifically, the study demonstrated that higher peak TnT levels are associated with a significantly greater risk of 30-day mortality. Moreover, 1.9% of patients died within 30 days after surgery, and of these 26.6% died after discharge from hospital.