The role of troponin I measurement in non cardiac aortic surgery
Research type
Research Study
Full title
Serial troponin I measurement as a predictor for peri operative morbidity and mortality in non-cardiac aortic surgery
IRAS ID
169796
Contact name
Steven Richardson
Contact email
Sponsor organisation
University Hospital of South Manchester
Clinicaltrials.gov Identifier
15/nw/0909, north west - preston
Duration of Study in the UK
1 years, 6 months, 30 days
Research summary
In the UK there is an aging surgical population with increasing co morbidities, and having the ability to stratify patients on cardiac risk and take appropriate measures will reduce morbidity and mortality. Vascular surgery is associated with a high risk of cardiovascular events and death. This project will determine the rates of perioperative elevation of the biomarker troponin I in non-cardiac vascular surgery. \n\nCardiovascular complications are the leading cause of morbidity and mortality in patients undergoing vascular surgery (1). Myocardial infarction and heart failure are the most common causes of morbidity and mortality in non-cardiac surgery. Mortality rates of patient with a perioperative myocardial infarction range from 30 – 50 %. Undiagnosed and untreated myocardial injury lowers survival post operatively and increases risk of death beyond hospital discharge. Clinical symptoms of ischaemia or evolving ECG changes will usually not identify these high risk patients. Biomarkers can be used to guide perioperative management. Troponin I is a simple blood test, and a highly sensitive and specific marker of myocardial injury, with a peak rise at 24 to 48 hours. \n\nEndovascular repair is associated with a decreased incidence of perioperative cardiac complications compared with open repair. Asymptomatic cardiac damage in patients undergoing EVAR is associated with poor long-term outcome.\n\nThe POISE Trial 2008(3) data suggested myocardial injury as a measured by postoperative Troponin I elevation, is the most common major vascular complication after major non cardiac surgery. The VISION 2012 trial (4) concluded among patients undergoing noncardiac surgery, the peak postoperative Troponin I measurement during the fist 3 days after surgery was significantly associated with 30-day mortality\n\nEarly identification of high risk patients, will allow early interventions to be applied to decrease the risk for the patient and improve their outcome.\n\n(References uploaded)
REC name
North West - Greater Manchester South Research Ethics Committee
REC reference
16/NW/0018
Date of REC Opinion
5 Jul 2016
REC opinion
Further Information Favourable Opinion