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Associations Between Cardiac Troponin, Mechanism of Myocardial Injury, and Long-Term Mortality After Non-Cardiac Vascular Surgery

Reed, Grant William

Abstract Details

2017, Master of Sciences, Case Western Reserve University, Clinical Research.
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.
Venu Menon, M.D. (Committee Chair)
Wilson Tang, M.D. (Advisor)
Rory Hachamovitch, M.D., M.Sc. (Committee Member)
49 p.

Recommended Citations

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)