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September 26, 2012

Troponin Levels and Mortality After Noncardiac Surgery

Author Affiliations

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

Author Affiliation: Jikei University of School of Medicine, Tokyo, Japan (tetsu@jg8.so-net.ne.jp).

JAMA. 2012;308(12):1204. doi:10.1001/2012.jama.11256

To the Editor: In the Vascular Events In Noncardiac Surgery Patients Cohort Evaluation (VISION) trial,1 higher cardiac troponin levels after noncardiac surgery were associated with increased 30-day mortality and shorter time from a peak troponin level to death. Monitoring of troponin level may have benefits in patients undergoing noncardiac surgery who have cardiovascular risks because there are many studies reporting the usefulness of troponin monitoring in acute and chronic cardiac diseases,2 but I am not convinced of its benefits in patients without cardiovascular risks. The data presented in eTable 2 of the article suggest a positive correlation between peak troponin levels and well-known cardiovascular risk factors. For instance, the proportion of patients with diabetes increased in parallel with the increase in peak troponin levels. Therefore, for patients with significant risks for cardiac events, perioperative monitoring of cardiac troponin may be useful to evaluate postoperative risk for cardiac events.