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GWR_Thesis_Formatted_Revised.pdf (1.36 MB)
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Associations Between Cardiac Troponin, Mechanism of Myocardial Injury, and Long-Term Mortality After Non-Cardiac Vascular Surgery
Author Info
Reed, Grant William
Permalink:
http://rave.ohiolink.edu/etdc/view?acc_num=case1491571890479287
Abstract Details
Year and Degree
2017, Master of Sciences, Case Western Reserve University, Clinical Research.
Abstract
It is unknown if long-term mortality after non-cardiac surgery differs by mechanism of myocardial injury. To assess this, 12,882 patients were assessed for cTnT sampling within 96-hours of vascular surgery. On Cox proportional hazards analysis, mortality was higher with any detectable cTnT compared to <0.01 ng/ml; cTnT 0.01-0.029 ng/ml (hazard ratio [HR] 1.54, 95% confidence interval [CI] 1.18-2.00), 0.03-0.099 ng/ml (HR 1.86, 95% CI 1.49-2.31), 0.10-0.399 ng/ml (HR 1.83, 95% CI 1.46-2.31), and >=0.40 ng/ml (HR 2.62, 95% CI 2.06-3.32). Compared to normal cTnT, baseline cTnT elevation was associated with increased mortality (HR 1.71, 95% CI 1.31-2.24), as were Type 2 myocardial infarction (MI) (HR 1.88, 95% CI 1.57-2.24), and Type 1 MI (HR 2.56, 95% CI 2.56, 1.82-3.60). Survival did not differ between mechanisms on Kaplan-Meier analysis. In conclusion, any detectable cTnT >=0.01 ng/ml is associated with long-term mortality after non-cardiac surgery, however, mortality is independent of mechanism.
Committee
Venu Menon, M.D. (Committee Chair)
Wilson Tang, M.D. (Advisor)
Rory Hachamovitch, M.D., M.Sc. (Committee Member)
Pages
49 p.
Subject Headings
Health
;
Health Care
;
Medicine
Keywords
myocardial infarction
;
myocardial injury
;
Type 1 MI
;
Type 2 MI
;
troponin
;
peri-operative myocardial injury
;
non-cardiac surgery
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Citations
Reed, G. W. (2017).
Associations Between Cardiac Troponin, Mechanism of Myocardial Injury, and Long-Term Mortality After Non-Cardiac Vascular Surgery
[Master's thesis, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1491571890479287
APA Style (7th edition)
Reed, Grant.
Associations Between Cardiac Troponin, Mechanism of Myocardial Injury, and Long-Term Mortality After Non-Cardiac Vascular Surgery.
2017. Case Western Reserve University, Master's thesis.
OhioLINK Electronic Theses and Dissertations Center
, http://rave.ohiolink.edu/etdc/view?acc_num=case1491571890479287.
MLA Style (8th edition)
Reed, Grant. "Associations Between Cardiac Troponin, Mechanism of Myocardial Injury, and Long-Term Mortality After Non-Cardiac Vascular Surgery." Master's thesis, Case Western Reserve University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=case1491571890479287
Chicago Manual of Style (17th edition)
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Document number:
case1491571890479287
Download Count:
570
Copyright Info
© 2017, all rights reserved.
This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.