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European Journal of Anaesthesiology:
doi: 10.1017/S0265021507001202
Original Article

Cardiac troponin I release after hip surgery correlates with poor long‐term cardiac outcome

Ausset, S.*; Auroy, Y.*; Lambert, E.*; Vest, P.; Plotton, C.; Rigal, S.; Lenoir, B.*; Benhamou, D.§

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Abstract

Background and objective:: The aim of this study was to assess the incidence of perioperative myocardial damage detected by serial measurements of troponin I after hip surgery and its association with late cardiovascular outcome.

Methods:: Troponin I was measured during the first three postoperative days in 88 consecutive patients undergoing hip surgery. Values above the 99th percentile (0.08 ng mL−1) were considered positive. Major cardiac events (cardiac death, myocardial infarction and cardiac failure) were recorded during hospital stay and 1 yr after surgery.

Results:: Eleven patients (12.5%) exhibited elevated troponin I levels during hospital stay. Nine of them remained asymptomatic. During follow‐up, 45% of them (5/11) suffered from a major cardiac event vs. 4% (3/76) for patients with normal postoperative troponin I levels (P = 0.0006). All‐cause mortality rate was 36% (4/11) at 1 yr vs. 7% (5/71, P = 0.0131). Using multivariate Cox regression analysis adjusted for baseline data, independent factors associated with the occurrence of a cardiac event were troponin I elevation (OR=17.4 ‐ CI 95% 3.7‐82) and age (OR=1.1 yr−1 ‐ CI 95% 1.01‐1.21). Independent factors for all‐cause mortality were troponin I elevation (OR=41.4 ‐ CI 95% 5.4‐320.4), and age (OR=1.3 yr−1 ‐ CI 95% 1.1‐1.4).

Conclusion:: Troponin I release is common after hip surgery and is associated with a 10‐fold increased incidence of long‐term major cardiac events as compared to patients with normal troponin I levels (45% vs. 4%).

© 2008 European Society of Anaesthesiology

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