Preoperative cardiac troponin below the 99th-percentile upper reference limit and 30-day mortality after noncardiac surgery
Preoperative high-sensitivity cardiac troponin (hs-cTn) above the 99th-percentile upper reference limit (URL) is associated with mortality after noncardiac surgery. This study aimed to evaluate whether preoperative hs-cTn concentrations above the lowest limit of detection (LOD) but below the 99th-pe...
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| creator | Park, Jungchan Hyeon, Cheol Won Lee, Seung-Hwa Lee, Sangmin Maria Yeo, Junghyun Yang, Kwangmo Min, Jeong Jin Lee, Jong Hwan Yang, Jeong Hoon Song, Young Bin Hahn, Joo-Yong Choi, Seung-Hyuk Choi, Jin-Ho Gwon, Hyeon-Cheol |
| description | Preoperative high-sensitivity cardiac troponin (hs-cTn) above the 99th-percentile upper reference limit (URL) is associated with mortality after noncardiac surgery. This study aimed to evaluate whether preoperative hs-cTn concentrations above the lowest limit of detection (LOD) but below the 99th-percentile URL can predict mortality after noncardiac surgery.From January 2010 to April 2019, a total of 12,415 noncardiac surgical patients with preoperative hs-cTn I below the 99th-percentile URL were enrolled. The patients were divided into two groups according to preoperative hs-cTn I concentration: (1) [hs-cTn] below the LOD (6 ng/L), and (2) mildly elevated [hs-cTn] but below the 99th-percentile URL (40 ng/L). The primary outcome was 30-day mortality. Of the 12,415 patients enrolled, 7958 (64.1%) were in the LOD group whereas 4457 (35.9%) were in the mild elevation group. The incidence of 30-day mortality was significantly greater in the mild elevation group (2.1% vs. 4.0% hazard ratio [HR] 1.73; 95% confidence interval [CI] 1.39–2.16; p |
| doi_str_mv | 10.1038/s41598-020-72853-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7550329</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2450670122</sourcerecordid><originalsourceid>FETCH-LOGICAL-c494t-a2ea20086c37494b8b36a928254284b737709f9f215fe72147be498c583642f3</originalsourceid><addsrcrecordid>eNp9kU1vFSEUhonR2Kb2D7gwLN2MMgcYYGNiGr-SJrronjDcM700MzACU3Pjn5d626ZuZMPHec4LvC8hr3v2rmdcvy-il0Z3DFinQEve8WfkFJiQHXCA50_WJ-S8lBvWhgQjevOSnHDOxKDkcEp-_8iYVsyuhluk3uVdcJ7WnNYUQ6QjzukXrXukxtR910CPsYYZ6ba2Dc04Ycbokc5hCZW6uKOcdTt3oEvK1c2hHqibakNjig_yZcvXmA-vyIvJzQXP7-czcvX509XF1-7y-5dvFx8vOy-MqJ0DdMCYHjxX7WDUIx-cAQ1SgBaj4koxM5kJejmhgl6oEYXRXmo-CJj4GflwlF23ccHd3Qeym-2aw-LywSYX7L-VGPb2Ot1aJSXjYJrA23uBnH5uWKpdQvE4zy5i2ooFIdmgWA_QUDiiPqdSmjuP1_TM3uVmj7nZlpv9m5vlrenN0wc-tjyk1AB-BEorxWadvUlbjs2z_8n-AUWNpRc</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2450670122</pqid></control><display><type>article</type><title>Preoperative cardiac troponin below the 99th-percentile upper reference limit and 30-day mortality after noncardiac surgery</title><source>MEDLINE</source><source>Nature Free</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><source>Free Full-Text Journals in Chemistry</source><source>Springer Nature OA Free Journals</source><creator>Park, Jungchan ; Hyeon, Cheol Won ; Lee, Seung-Hwa ; Lee, Sangmin Maria ; Yeo, Junghyun ; Yang, Kwangmo ; Min, Jeong Jin ; Lee, Jong Hwan ; Yang, Jeong Hoon ; Song, Young Bin ; Hahn, Joo-Yong ; Choi, Seung-Hyuk ; Choi, Jin-Ho ; Gwon, Hyeon-Cheol</creator><creatorcontrib>Park, Jungchan ; Hyeon, Cheol Won ; Lee, Seung-Hwa ; Lee, Sangmin Maria ; Yeo, Junghyun ; Yang, Kwangmo ; Min, Jeong Jin ; Lee, Jong Hwan ; Yang, Jeong Hoon ; Song, Young Bin ; Hahn, Joo-Yong ; Choi, Seung-Hyuk ; Choi, Jin-Ho ; Gwon, Hyeon-Cheol</creatorcontrib><description>Preoperative high-sensitivity cardiac troponin (hs-cTn) above the 99th-percentile upper reference limit (URL) is associated with mortality after noncardiac surgery. This study aimed to evaluate whether preoperative hs-cTn concentrations above the lowest limit of detection (LOD) but below the 99th-percentile URL can predict mortality after noncardiac surgery.From January 2010 to April 2019, a total of 12,415 noncardiac surgical patients with preoperative hs-cTn I below the 99th-percentile URL were enrolled. The patients were divided into two groups according to preoperative hs-cTn I concentration: (1) [hs-cTn] below the LOD (6 ng/L), and (2) mildly elevated [hs-cTn] but below the 99th-percentile URL (40 ng/L). The primary outcome was 30-day mortality. Of the 12,415 patients enrolled, 7958 (64.1%) were in the LOD group whereas 4457 (35.9%) were in the mild elevation group. The incidence of 30-day mortality was significantly greater in the mild elevation group (2.1% vs. 4.0% hazard ratio [HR] 1.73; 95% confidence interval [CI] 1.39–2.16; p < 0.001) in the multivariate analyses. The propensity score matched analyses also produced a similar result (2.6% vs. 4.2% HR 1.61; 95% CI 1.26–2.07; p < 0.001). The threshold at which the risk of mortality increased corresponded to a preoperative hs-cTn I ≥ 12 ng/L. Patients with preoperative hs-cTn I above the LOD and below the 99th-percentile URL had greater 30-day mortality after noncardiac surgery.</description><identifier>ISSN: 2045-2322</identifier><identifier>EISSN: 2045-2322</identifier><identifier>DOI: 10.1038/s41598-020-72853-3</identifier><identifier>PMID: 33046756</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308 ; 692/4019 ; 692/53 ; Adult ; Aged ; Biomarkers - blood ; Female ; Hospital Mortality ; Humanities and Social Sciences ; Humans ; Male ; Middle Aged ; multidisciplinary ; Preoperative Period ; Reference Values ; Science ; Science (multidisciplinary) ; Surgical Procedures, Operative - mortality ; Troponin I - blood</subject><ispartof>Scientific reports, 2020-10, Vol.10 (1), p.17007-17007, Article 17007</ispartof><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c494t-a2ea20086c37494b8b36a928254284b737709f9f215fe72147be498c583642f3</citedby><cites>FETCH-LOGICAL-c494t-a2ea20086c37494b8b36a928254284b737709f9f215fe72147be498c583642f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7550329/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7550329/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,41096,42165,51551,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33046756$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, Jungchan</creatorcontrib><creatorcontrib>Hyeon, Cheol Won</creatorcontrib><creatorcontrib>Lee, Seung-Hwa</creatorcontrib><creatorcontrib>Lee, Sangmin Maria</creatorcontrib><creatorcontrib>Yeo, Junghyun</creatorcontrib><creatorcontrib>Yang, Kwangmo</creatorcontrib><creatorcontrib>Min, Jeong Jin</creatorcontrib><creatorcontrib>Lee, Jong Hwan</creatorcontrib><creatorcontrib>Yang, Jeong Hoon</creatorcontrib><creatorcontrib>Song, Young Bin</creatorcontrib><creatorcontrib>Hahn, Joo-Yong</creatorcontrib><creatorcontrib>Choi, Seung-Hyuk</creatorcontrib><creatorcontrib>Choi, Jin-Ho</creatorcontrib><creatorcontrib>Gwon, Hyeon-Cheol</creatorcontrib><title>Preoperative cardiac troponin below the 99th-percentile upper reference limit and 30-day mortality after noncardiac surgery</title><title>Scientific reports</title><addtitle>Sci Rep</addtitle><addtitle>Sci Rep</addtitle><description>Preoperative high-sensitivity cardiac troponin (hs-cTn) above the 99th-percentile upper reference limit (URL) is associated with mortality after noncardiac surgery. This study aimed to evaluate whether preoperative hs-cTn concentrations above the lowest limit of detection (LOD) but below the 99th-percentile URL can predict mortality after noncardiac surgery.From January 2010 to April 2019, a total of 12,415 noncardiac surgical patients with preoperative hs-cTn I below the 99th-percentile URL were enrolled. The patients were divided into two groups according to preoperative hs-cTn I concentration: (1) [hs-cTn] below the LOD (6 ng/L), and (2) mildly elevated [hs-cTn] but below the 99th-percentile URL (40 ng/L). The primary outcome was 30-day mortality. Of the 12,415 patients enrolled, 7958 (64.1%) were in the LOD group whereas 4457 (35.9%) were in the mild elevation group. The incidence of 30-day mortality was significantly greater in the mild elevation group (2.1% vs. 4.0% hazard ratio [HR] 1.73; 95% confidence interval [CI] 1.39–2.16; p < 0.001) in the multivariate analyses. The propensity score matched analyses also produced a similar result (2.6% vs. 4.2% HR 1.61; 95% CI 1.26–2.07; p < 0.001). The threshold at which the risk of mortality increased corresponded to a preoperative hs-cTn I ≥ 12 ng/L. Patients with preoperative hs-cTn I above the LOD and below the 99th-percentile URL had greater 30-day mortality after noncardiac surgery.</description><subject>692/308</subject><subject>692/4019</subject><subject>692/53</subject><subject>Adult</subject><subject>Aged</subject><subject>Biomarkers - blood</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>multidisciplinary</subject><subject>Preoperative Period</subject><subject>Reference Values</subject><subject>Science</subject><subject>Science (multidisciplinary)</subject><subject>Surgical Procedures, Operative - mortality</subject><subject>Troponin I - blood</subject><issn>2045-2322</issn><issn>2045-2322</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kU1vFSEUhonR2Kb2D7gwLN2MMgcYYGNiGr-SJrronjDcM700MzACU3Pjn5d626ZuZMPHec4LvC8hr3v2rmdcvy-il0Z3DFinQEve8WfkFJiQHXCA50_WJ-S8lBvWhgQjevOSnHDOxKDkcEp-_8iYVsyuhluk3uVdcJ7WnNYUQ6QjzukXrXukxtR910CPsYYZ6ba2Dc04Ycbokc5hCZW6uKOcdTt3oEvK1c2hHqibakNjig_yZcvXmA-vyIvJzQXP7-czcvX509XF1-7y-5dvFx8vOy-MqJ0DdMCYHjxX7WDUIx-cAQ1SgBaj4koxM5kJejmhgl6oEYXRXmo-CJj4GflwlF23ccHd3Qeym-2aw-LywSYX7L-VGPb2Ot1aJSXjYJrA23uBnH5uWKpdQvE4zy5i2ooFIdmgWA_QUDiiPqdSmjuP1_TM3uVmj7nZlpv9m5vlrenN0wc-tjyk1AB-BEorxWadvUlbjs2z_8n-AUWNpRc</recordid><startdate>20201012</startdate><enddate>20201012</enddate><creator>Park, Jungchan</creator><creator>Hyeon, Cheol Won</creator><creator>Lee, Seung-Hwa</creator><creator>Lee, Sangmin Maria</creator><creator>Yeo, Junghyun</creator><creator>Yang, Kwangmo</creator><creator>Min, Jeong Jin</creator><creator>Lee, Jong Hwan</creator><creator>Yang, Jeong Hoon</creator><creator>Song, Young Bin</creator><creator>Hahn, Joo-Yong</creator><creator>Choi, Seung-Hyuk</creator><creator>Choi, Jin-Ho</creator><creator>Gwon, Hyeon-Cheol</creator><general>Nature Publishing Group UK</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20201012</creationdate><title>Preoperative cardiac troponin below the 99th-percentile upper reference limit and 30-day mortality after noncardiac surgery</title><author>Park, Jungchan ; Hyeon, Cheol Won ; Lee, Seung-Hwa ; Lee, Sangmin Maria ; Yeo, Junghyun ; Yang, Kwangmo ; Min, Jeong Jin ; Lee, Jong Hwan ; Yang, Jeong Hoon ; Song, Young Bin ; Hahn, Joo-Yong ; Choi, Seung-Hyuk ; Choi, Jin-Ho ; Gwon, Hyeon-Cheol</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c494t-a2ea20086c37494b8b36a928254284b737709f9f215fe72147be498c583642f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>692/308</topic><topic>692/4019</topic><topic>692/53</topic><topic>Adult</topic><topic>Aged</topic><topic>Biomarkers - blood</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>multidisciplinary</topic><topic>Preoperative Period</topic><topic>Reference Values</topic><topic>Science</topic><topic>Science (multidisciplinary)</topic><topic>Surgical Procedures, Operative - mortality</topic><topic>Troponin I - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, Jungchan</creatorcontrib><creatorcontrib>Hyeon, Cheol Won</creatorcontrib><creatorcontrib>Lee, Seung-Hwa</creatorcontrib><creatorcontrib>Lee, Sangmin Maria</creatorcontrib><creatorcontrib>Yeo, Junghyun</creatorcontrib><creatorcontrib>Yang, Kwangmo</creatorcontrib><creatorcontrib>Min, Jeong Jin</creatorcontrib><creatorcontrib>Lee, Jong Hwan</creatorcontrib><creatorcontrib>Yang, Jeong Hoon</creatorcontrib><creatorcontrib>Song, Young Bin</creatorcontrib><creatorcontrib>Hahn, Joo-Yong</creatorcontrib><creatorcontrib>Choi, Seung-Hyuk</creatorcontrib><creatorcontrib>Choi, Jin-Ho</creatorcontrib><creatorcontrib>Gwon, Hyeon-Cheol</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Scientific reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, Jungchan</au><au>Hyeon, Cheol Won</au><au>Lee, Seung-Hwa</au><au>Lee, Sangmin Maria</au><au>Yeo, Junghyun</au><au>Yang, Kwangmo</au><au>Min, Jeong Jin</au><au>Lee, Jong Hwan</au><au>Yang, Jeong Hoon</au><au>Song, Young Bin</au><au>Hahn, Joo-Yong</au><au>Choi, Seung-Hyuk</au><au>Choi, Jin-Ho</au><au>Gwon, Hyeon-Cheol</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative cardiac troponin below the 99th-percentile upper reference limit and 30-day mortality after noncardiac surgery</atitle><jtitle>Scientific reports</jtitle><stitle>Sci Rep</stitle><addtitle>Sci Rep</addtitle><date>2020-10-12</date><risdate>2020</risdate><volume>10</volume><issue>1</issue><spage>17007</spage><epage>17007</epage><pages>17007-17007</pages><artnum>17007</artnum><issn>2045-2322</issn><eissn>2045-2322</eissn><abstract>Preoperative high-sensitivity cardiac troponin (hs-cTn) above the 99th-percentile upper reference limit (URL) is associated with mortality after noncardiac surgery. This study aimed to evaluate whether preoperative hs-cTn concentrations above the lowest limit of detection (LOD) but below the 99th-percentile URL can predict mortality after noncardiac surgery.From January 2010 to April 2019, a total of 12,415 noncardiac surgical patients with preoperative hs-cTn I below the 99th-percentile URL were enrolled. The patients were divided into two groups according to preoperative hs-cTn I concentration: (1) [hs-cTn] below the LOD (6 ng/L), and (2) mildly elevated [hs-cTn] but below the 99th-percentile URL (40 ng/L). The primary outcome was 30-day mortality. Of the 12,415 patients enrolled, 7958 (64.1%) were in the LOD group whereas 4457 (35.9%) were in the mild elevation group. The incidence of 30-day mortality was significantly greater in the mild elevation group (2.1% vs. 4.0% hazard ratio [HR] 1.73; 95% confidence interval [CI] 1.39–2.16; p < 0.001) in the multivariate analyses. The propensity score matched analyses also produced a similar result (2.6% vs. 4.2% HR 1.61; 95% CI 1.26–2.07; p < 0.001). The threshold at which the risk of mortality increased corresponded to a preoperative hs-cTn I ≥ 12 ng/L. Patients with preoperative hs-cTn I above the LOD and below the 99th-percentile URL had greater 30-day mortality after noncardiac surgery.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>33046756</pmid><doi>10.1038/s41598-020-72853-3</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 692/308 692/4019 692/53 Adult Aged Biomarkers - blood Female Hospital Mortality Humanities and Social Sciences Humans Male Middle Aged multidisciplinary Preoperative Period Reference Values Science Science (multidisciplinary) Surgical Procedures, Operative - mortality Troponin I - blood |
| title | Preoperative cardiac troponin below the 99th-percentile upper reference limit and 30-day mortality after noncardiac surgery |
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