4.4 Review

Expert consensus on peri-operative myocardial injury screening in noncardiac surgery A literature review

Journal

EUROPEAN JOURNAL OF ANAESTHESIOLOGY
Volume 38, Issue 6, Pages 600-608

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/EJA.0000000000001486

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Funding

  1. Roche Diagnostics

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This article summarizes local examples of successfully implemented cTn screening practices and reviews current literature to provide information and suggestions on patient selection, organization of a screening program, and potential management pathways for peri-operative myocardial injury.
Peri-operative myocardial injury, detected by dynamic and elevated cardiac troponin (cTn) concentrations, is a common complication of noncardiac surgery that is strongly associated with 30-day mortality. Although active screening for peri-operative myocardial injury has been suggested in recent guidelines, clinical implementation remains tentative due to a lack of examples on how to tackle such an interdisciplinary project at a local level. Moreover, consensus on which assay and cTn cut-off values should be used has not yet been reached, and guidance on whom to screen is lacking. In this article, we aim to summarise local examples of successfully implemented cTn screening practices and review the current literature in order to provide information and suggestions for patient selection, organisation of a screening programme, caveats and a potential management pathway.

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