Document Detail


Outcomes in vascular surgical patients with isolated postoperative troponin leak: a meta-analysis.
MedLine Citation:
PMID:  21564046     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Although peri-operative myocardial infarction remains a significant cause of morbidity and mortality following vascular surgery, the significance of an isolated troponin leak is uncertain. This is an elevation of troponin below the diagnostic threshold for a peri-operative myocardial infarction, without symptoms or ischaemic electrocardiography changes or echocardiography signs such as new regional wall motion abnormalities. This meta-analysis aimed to determine the early (< 30 days) and intermediate (< 180 days) outcomes of vascular surgical patients with an isolated troponin leak. A full literature search up to December 2010 identified 593 studies, of which nine (consisting of eight distinct patient cohorts) underwent analysis. An isolated troponin leak was strongly predictive of all-cause mortality at 30 days (OR 5.03, 95% CI 2.88-8.79, p < 0.00001). The associated 30-day mortality in patients with no troponin elevation, an isolated troponin leak or peri-operative myocardial infarction was 2.3%, 11.6% and 21.6%, respectively (p = 0.000001). Insufficient data were available to analyse intermediate-term outcomes. An isolated troponin leak following vascular surgery is strongly associated with short-term mortality.
Authors:
G Redfern; R N Rodseth; B M Biccard
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-13
Journal Detail:
Title:  Anaesthesia     Volume:  -     ISSN:  1365-2044     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.
Affiliation:
 Registrar  Consultant, Perioperative Research Unit, Department of Anaesthetics, Nelson R Mandela School of Medicine, KwaZulu-Natal, South Africa  Consultant, Inkosi Albert Luthuli Central Hospital, Mayville, South Africa.
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