High postoperative TnT is a strong predictor of 30-day mortality in non-cardiac surgery .
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Association between postoperative troponin levels and 30-day mortality among patients undergoing noncardiac surgery
JAMA. 2012 Jun 6;307(21):2295-304. doi: 10.1001/jama.2012.5502.15,133 patients (45 years or older) undergoing non-cardiac surgery were included in this study (the VISION fourth-generation TnT prognostic study). The purpose of this large, international prospective cohort study was to determine whether peak postoperative troponin-T (TnT) values are associated with 30-day mortality rates. Results indicated that peak postoperative TnT values were the strongest predictors for 30-day mortality rates in this patient population. The median time from the peak TnT measurement to death became shorter with increasing peak TnT values. The net re-classification improvement (for risk categories) associated with assessing postoperative TnT values was 25.0%, compared to the assessment of preoperative risk factors only. According to the population attributable risk analysis, high TnT values in the postoperative period may explain 41.8% of deaths.
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