Natriuretic Peptides and Troponins to Predict Cardiovascular Events in Patients Undergoing Major Non-Cardiac Surgery

Marco Alfonso Perrone, Alberto Aimo, Sergio Bernardini and Aldo Clerico
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Marco Alfonso Perrone: Department of Cardiology, University of Rome Tor Vergata, 00133 Rome, Italy
Alberto Aimo: Fondazione CNR Regione Toscana G. Monasterio, 56124 Pisa, Italy
Sergio Bernardini: Department of Experimental Medicine and CardioLab, University of Rome Tor Vergata, 00133 Rome, Italy
Aldo Clerico: Fondazione CNR Regione Toscana G. Monasterio, 56124 Pisa, Italy

IJERPH, 2022, vol. 19, issue 9, 1-19

Abstract: Patients undergoing major surgery have a substantial risk of cardiovascular events during the perioperative period. Despite the introduction of several risk scores based on medical history, classical risk factors and non-invasive cardiac tests, the possibility of predicting cardiovascular events in patients undergoing non-cardiac surgery remains limited. The cardiac-specific biomarkers, natriuretic peptides (NPs) and cardiac troponins (cTn) have been proposed as additional tools for risk prediction in the perioperative period. This review paper aims to discuss the value of preoperative levels and perioperative changes in cardiac-specific biomarkers to predict adverse outcomes in patients undergoing major non-cardiac surgery. Based on several prospective observational studies and six meta-analyses, some guidelines recommended the measurement of NPs to refine perioperative cardiac risk estimation in patients undergoing non-cardiac surgery. More recently, several studies reported a higher mortality in surgical patients presenting an elevation in high-sensitivity cardiac troponin T and I, especially in elderly patients or those with comorbidities. This evidence should be considered in future international guidelines on the evaluation of perioperative risk in patients undergoing major non-cardiac surgery.

Keywords: cardiac troponins; high-sensitivity methods; cardiac natriuretic peptides; non-cardiac surgery; cardiovascular risk (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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