Article ; Online: Evaluation of the cardiovascular risk in patients undergoing major non-cardiac surgery: role of cardiac-specific biomarkers.
Clinical chemistry and laboratory medicine
2022 Volume 60, Issue 10, Page(s) 1525–1542
Abstract: Major adverse cardiovascular events are frequently observed in patients undergoing major non-cardiac surgery during the peri-operative period. At this time, the possibility to predict cardiovascular events remains limited, despite the introduction of ... ...
| Abstract | Major adverse cardiovascular events are frequently observed in patients undergoing major non-cardiac surgery during the peri-operative period. At this time, the possibility to predict cardiovascular events remains limited, despite the introduction of several algorithms to calculate the risk of adverse events, mainly death and major adverse cardiovascular events (MACE) based on the clinical history, risk factors (sex, age, lipid profile, serum creatinine) and non-invasive cardiac exams (electrocardiogram, echocardiogram, stress tests). The cardiac-specific biomarkers natriuretic peptides (NPs) and cardiac troponins (cTn) have been proposed as additional tools for risk prediction in the peri-operative period, particularly for the identification of myocardial injury in patients undergoing major non-cardiac surgery. The prognostic information from the measurement of BNP/NT-proBNP and hs-cTn is independent and complementary to other important indicators of risk, also including ECG and imaging techniques. Elevated levels of cardiac-specific biomarkers before surgery are associated with a markedly higher risk of MACE during the peri-operative period. BNP/NT-proBNP and hs-cTn should be measured in all patients during the clinical evaluation before surgery, particularly during intermediate- or high-risk surgery, in patients aged >65 years and/or with comorbidities. Several questions remain to be assessed in dedicated clinical studies, such as how to optimize the management of patients with raised cardiac specific biomarkers before surgery, and whether a strategy based on biomarker measurement improves patient outcomes and is cost-effective. |
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| MeSH term(s) | Biomarkers ; Cardiovascular Diseases ; Heart Disease Risk Factors ; Humans ; Natriuretic Peptide, Brain ; Peptide Fragments ; Prognosis ; Risk Assessment ; Risk Factors | |||||
| Chemical Substances | Biomarkers ; Peptide Fragments ; Natriuretic Peptide, Brain (114471-18-0) | |||||
| Language | English | |||||
| Publishing date | 2022-07-20 | |||||
| Publishing country | Germany | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 1418007-8 | |||||
| ISSN | 1437-4331 ; 1434-6621 ; 1437-8523 | |||||
| ISSN (online) | 1437-4331 | |||||
| ISSN | 1434-6621 ; 1437-8523 | |||||
| DOI | 10.1515/cclm-2022-0481 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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