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Study challenges troponin limits for determining heart damage after cardiac surgery


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Journal
The New England Journal of Medicine
Reuters Health - 02/03/2022 - Conventional wisdom says that cardiac troponin levels that are 10 times or even over 70 times higher than the upper reference level indicate a perioperative myocardial infarction or a clinically important periprocedural myocardial injury in people who have just had heart surgery. But a new study concludes that those limits are wildly off the mark. The 30-day risk of death doesn't go up until troponin levels hit 218 times the reference limit, according to an assessment of 8,239 patients who had coronary-artery-bypass grafting or either aortic-valve replacement or repair. For 5,623 patients who underwent other cardiac surgery, troponin levels had to hit 499 times the reference limit before the risk of death was elevated. Chief author Dr. P.J. Devereaux of McMaster University in Hamilton, Canada, told Reuters Health in a telephone interview that because virtually every heart-surgery patient exceeds that 10-fold limit and thei...


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