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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP-
dc.contributor.authorGUALANDRO, Danielle M.-
dc.contributor.authorPUELACHER, Christian-
dc.contributor.authorLURATIBUSE, Giovanna-
dc.contributor.authorLAMPART, Andreas-
dc.contributor.authorSTRUNZ, Celia-
dc.contributor.authorCARDOZO, Francisco A.-
dc.contributor.authorYU, Pai C.-
dc.contributor.authorJAFFE, Allan S.-
dc.contributor.authorBARAC, Sanela-
dc.contributor.authorBOCK, Lukas-
dc.contributor.authorBADERTSCHER, Patrick-
dc.contributor.authorLAVALLAZ, Jeanne du Fay de-
dc.contributor.authorMARBOT, Stella-
dc.contributor.authorSAZGARY, Lorraine-
dc.contributor.authorBOLLIGER, Daniel-
dc.contributor.authorRENTSCH, Katharina-
dc.contributor.authorTWERENBOLD, Raphael-
dc.contributor.authorHAMMERER-LERCHER, Angelika-
dc.contributor.authorMELO, Edielle S.-
dc.contributor.authorCALDERARO, Daniela-
dc.contributor.authorDUARTE, Alberto J. S.-
dc.contributor.authorLUCCIA, Nelson de-
dc.contributor.authorCARAMELLI, Bruno-
dc.contributor.authorMUELLER, Christian-
dc.identifier.citationAMERICAN HEART JOURNAL, v.203, p.67-73, 2018-
dc.description.abstractBackground: We aimed to directly compare preoperative high-sensitivity cardiac troponin (hs-cTn) I and T concentration for the prediction of major cardiac complications after non-cardiac surgery. Methods: We measured hs-cTnI and hs-cTnT preoperatively in a blinded fashion in 1022 patients undergoing non-cardiac surgery. The primary endpoint was a composite of major cardiac complications including cardiac death, cardiac arrest, myocardial infarction, clinically relevant arrhythmias, and acute heart failure within 30 days. We hypothesized that the type of surgery may impact on the predictive accuracy of hs-cTnI/T and stratified all analyses according to the type of surgery. Results: Major cardiac complications occurred in 108 (11%) patients, 58/243 (24%) patients undergoing vascular surgery and 50/779 (6%, P < .001) patients undergoing non-vascular surgery. Using regulatory-approved 99th percentile cut-off concentrations, preoperative hs-cTnI elevations were less than one-fifth as common as preoperative hs-cTnT elevations (P < .001). Among patients undergoing vascular surgery, preoperative hs-cTnI concentrations, but not hs-cTnT, was an independent predictor of cardiac complications (adjusted odds ratio (aOR) 1.5, 95% confidence interval (95% CI) 1.0-2.1). The area under the receiver-operating characteristics curve (AUC) was 0.67 (95% CI, 0.59-0.75) for hs-cTnI versus 0.59 (95% CI 0.51-0.67, P=.012) for hs-cTnT. In contrast, among patients undergoing non-vascular surgery both preoperative hs-cTnI and hs-cTnT were independent predictors of the primary endpoint (aOR 1.6, 95% CI 1.3-2.0, and aOR 3.0, 95% CI 2.0-4.6, respectively) and showed higher predictive accuracy (AUC 0.77, 95% CI, 0.71-0.83, and 0.79, 95% CI 0.73-0.85, P = ns). Conclusions: Preoperative hs-cTnI and hs-cTnT concentrations predict major cardiac complications after non-vascular surgery, while, in patients undergoing vascular surgery, hs-cTnI may have better accuracy.-
dc.description.sponsorshipFAPESP (Sao Paulo Research Foundation)-
dc.description.sponsorshipSwiss National Science Foundation [P300PB-167, 803/1]-
dc.description.sponsorshipSwiss Heart Foundation-
dc.description.sponsorshipAstra Zeneca-
dc.description.sponsorshipUniversity of Basel-
dc.relation.ispartofAmerican Heart Journal-
dc.subject.otheracute myocardial-infarction-
dc.titleComparison of high-sensitivity cardiac troponin I and T for the prediction of cardiac complications after non-cardiac surgery-
dc.rights.holderCopyright MOSBY-ELSEVIER-
dc.contributor.groupauthorTropoVasc Investigator-
dc.contributor.groupauthorBASEL-PMI Investigator-
dc.subject.wosCardiac & Cardiovascular Systems-
dc.type.categoryoriginal article-
dc.type.versionpublishedVersion-, Christian:Univ Basel, Univ Hosp Basel, Dept Cardiol, Basel, Switzerland-, Giovanna:Univ Hosp Dusseldorf, Dept Anaesthesiol, Dusseldorf, Germany; Univ Basel, Univ Hosp Basel, Dept Anaesthesiol, Basel, Switzerland-, Andreas:Univ Basel, Univ Hosp Basel, Dept Anaesthesiol, Basel, Switzerland-, Allan S.:Mayo Clin, Dept Cardiol, Rochester, MI USA; Mayo Clin, Dept Lab Med & Pathol, Rochester, MI USA-, Sanela:Univ Basel, Univ Hosp Basel, Dept Cardiol, Basel, Switzerland-, Lukas:Univ Basel, Univ Hosp Basel, Dept Cardiol, Basel, Switzerland-, Patrick:Univ Basel, Univ Hosp Basel, Dept Cardiol, Basel, Switzerland-, Jeanne du Fay de:Univ Basel, Univ Hosp Basel, Dept Cardiol, Basel, Switzerland-, Stella:Univ Basel, Univ Hosp Basel, Dept Cardiol, Basel, Switzerland-, Lorraine:Univ Basel, Univ Hosp Basel, Dept Cardiol, Basel, Switzerland-, Daniel:Univ Basel, Univ Hosp Basel, Dept Anaesthesiol, Basel, Switzerland-, Katharina:Univ Hosp Basel, Dept Lab Med, Basel, Switzerland-, Raphael:Univ Basel, Univ Hosp Basel, Dept Cardiol, Basel, Switzerland; Hamburg Univ, Heart Ctr, Dept Gen & Intervent Cardiol, Hamburg, Germany-, Angelika:Cantonal Hosp Aarau, Dept Lab Med, Aarau, Switzerland-, Christian:Univ Basel, Univ Hosp Basel, Dept Cardiol, Basel, Switzerland-
hcfmusp.publisher.cityNEW YORK-
hcfmusp.relation.referenceAmmann P, 2001, INTENS CARE MED, V27, P965, DOI 10.1007/s001340100920-
hcfmusp.relation.referenceANDERSON PAW, 1991, CIRC RES, V69, P1226, DOI 10.1161/01.RES.69.5.1226-
hcfmusp.relation.referenceApple FS, 2009, CLIN CHEM, V55, P1303, DOI 10.1373/clinchem.2009.128363-
hcfmusp.relation.referenceBoeddinghaus J, 2017, CIRCULATION, V135, P1597, DOI 10.1161/CIRCULATIONAHA.116.025661-
hcfmusp.relation.referenceBossard M, 2017, CLIN RES CARDIOL, V106, P96, DOI 10.1007/s00392-016-1026-5-
hcfmusp.relation.referenceDevereaux PJ, 2017, JAMA-J AM MED ASSOC, V317, P1642, DOI 10.1001/jama.2017.4360-
hcfmusp.relation.referenceGillmann HJ, 2014, CRIT CARE MED, V42, P1498, DOI 10.1097/CCM.0000000000000249-
hcfmusp.relation.referenceGualandro DM, 2017, J VASC SURG, V66, P1826, DOI 10.1016/j.jvs.2017.05.100-
hcfmusp.relation.referenceGualandro DM, 2012, ATHEROSCLEROSIS, V222, P191, DOI 10.1016/j.atherosclerosis.2012.02.021-
hcfmusp.relation.referenceGUALANDRO DM, 2017, ARQ BRAS CARDIOL S1, V109-
hcfmusp.relation.referenceHicks KA, 2015, CIRCULATION, V132, P302, DOI 10.1161/CIR.0000000000000156-
hcfmusp.relation.referenceJaffe AS, 2011, J AM COLL CARDIOL, V58, P1819, DOI 10.1016/j.jacc.2011.08.026-
hcfmusp.relation.referenceKavsak PA, 2011, CLIN BIOCHEM, V44, P1021, DOI 10.1016/j.clinbiochem.2011.05.017-
hcfmusp.relation.referenceKimenai DM, 2016, HEART, V102, P610, DOI 10.1136/heartjnl-2015-308917-
hcfmusp.relation.referenceKoerbin G, 2012, CLIN CHEM LAB MED, V50, P871, DOI 10.1515/cclm-2011-0540-
hcfmusp.relation.referenceKristensen SD, 2014, EUR HEART J, V35, P2383, DOI 10.1093/eurheartj/ehu282-
hcfmusp.relation.referenceLee TH, 1999, CIRCULATION, V100, P1043, DOI 10.1161/01.CIR.100.10.1043-
hcfmusp.relation.referenceMueller C, 2017, EUR HEART J-ACUTE CA, V6, P81, DOI 10.1177/2048872615593279-
hcfmusp.relation.referenceNagele P, 2013, AM HEART J, V166, P325, DOI 10.1016/j.ahj.2013.04.018-
hcfmusp.relation.referenceNestelberger T, 2016, INT J CARDIOL, V207, P238, DOI 10.1016/j.ijcard.2016.01.112-
hcfmusp.relation.referenceNoordzij PG, 2015, BRIT J ANAESTH, V114, P909, DOI 10.1093/bja/aev027-
hcfmusp.relation.referencePearse RM, 2012, LANCET, V380, P1059, DOI 10.1016/S0140-6736(12)61148-9-
hcfmusp.relation.referencePonikowski P, 2016, EUR HEART J, V37, P2129, DOI 10.1093/eurheartj/ehw128-
hcfmusp.relation.referencePrice S, 2017, NAT REV CARDIOL, V14, P426, DOI 10.1038/nrcardio.2017.56-
hcfmusp.relation.referencePuelacher C, 2018, CIRCULATION, V137, P1221, DOI 10.1161/CIRCULATIONAHA.117.030114-
hcfmusp.relation.referenceRobin X, 2011, BMC BIOINFORMATICS, V12, DOI 10.1186/1471-2105-12-77-
hcfmusp.relation.referenceSaaby L, 2013, AM J MED, V126, P789, DOI 10.1016/j.amjmed.2013.02.029-
hcfmusp.relation.referenceThygesen K, 2012, J AM COLL CARDIOL, V60, P1581, DOI 10.1016/j.jacc.2012.08.001-
hcfmusp.relation.referenceUngerer JPJ, 2016, CLIN CHEM, V62, P1106, DOI 10.1373/clinchem.2016.255281-
hcfmusp.relation.referencevan der Linden N, 2017, CIRCULATION, V136, P1073, DOI 10.1161/CIRCULATIONAHA.117.029986-
hcfmusp.relation.referenceVestergaard KR, 2016, INT J CARDIOL, V222, P819, DOI 10.1016/j.ijcard.2016.07.166-
hcfmusp.relation.referenceWeber M, 2013, EUR HEART J, V34, P853, DOI 10.1093/eurheartj/ehs445-
hcfmusp.relation.referenceWeiser TG, 2015, LANCET, V385, P11, DOI 10.1016/S0140-6736(15)60806-6-
hcfmusp.relation.referenceWildi K, 2015, CIRCULATION, V131, P2032, DOI 10.1161/CIRCULATIONAHA.114.014129-
hcfmusp.relation.referenceWorld Health Organization, 2011, HAEM CONC DIAGN AN A-
hcfmusp.relation.referenceYu PC, 2010, PLOS ONE, V5, DOI 10.1371/journal.pone.0010607-
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Artigos e Materiais de Revistas Científicas - FM/MCG
Departamento de Cirurgia - FM/MCG

Artigos e Materiais de Revistas Científicas - FM/MCP
Departamento de Cardio-Pneumologia - FM/MCP

Artigos e Materiais de Revistas Científicas - FM/MPT
Departamento de Patologia - FM/MPT

Artigos e Materiais de Revistas Científicas - HC/ICESP
Instituto do Câncer do Estado de São Paulo - HC/ICESP

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - HC/InCor
Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - LIM/02
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica

Artigos e Materiais de Revistas Científicas - LIM/56
LIM/56 - Laboratório de Investigação em Dermatologia e Imunodeficiências

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