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September 26, 2012

Troponin Levels and Mortality After Noncardiac Surgery—Reply

P. J. Devereaux, MD, PhD; Matthew T. V. Chan, MD, MSc; Pablo Alonso-Coello, MD, MSc; et al on behalf of the Vascular Events In Noncardiac Surgery Patients Cohort Evaluation (VISION) Study Investigators
Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (Dr Devereaux; philipj@mcmaster.ca); Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China (Dr Chan); and Iberoamerican Cochrane Center, Biomedical Research Institute Sant Pau, Barcelona, Spain (Dr Alonso-Coello).

JAMA. 2012;308(12):1204-1205. doi:10.1001/2012.jama.11268

In Reply: Based on the VISION data, Dr Fujita suggests there is merit in monitoring troponin measurements after noncardiac surgery in patients with cardiovascular risks but not in patients at low-risk of a major cardiac event. We agree with this perspective and believe that the focus should be on monitoring perioperative troponin levels in patients with cardiovascular disease or risk factors for atherosclerotic disease (ie, the patients at highest risk of experiencing an elevated perioperative troponin level).

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