Detected troponin elevation is associated with high early mortality after lung resection for cancer
<p>Abstract</p> <p>Background</p> <p>Myocardial infarction can be difficult to diagnose after lung surgery. As recent diagnostic criteria emphasize serum cardiac markers (in particular serum troponin) we set out to evaluate its clinical utility and to establish the long...
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doaj-0d537387c99643a196c53d06cc846aec2020-11-24T22:19:34ZengBMCJournal of Cardiothoracic Surgery1749-80902006-10-01113710.1186/1749-8090-1-37Detected troponin elevation is associated with high early mortality after lung resection for cancerVan Tornout FillipMussa ShafiFlaks LydiaLi Choy LiLim EricVan Leuven MarcParry G Wyn<p>Abstract</p> <p>Background</p> <p>Myocardial infarction can be difficult to diagnose after lung surgery. As recent diagnostic criteria emphasize serum cardiac markers (in particular serum troponin) we set out to evaluate its clinical utility and to establish the long term prognostic impact of detected abnormal postoperative troponin levels after lung resection.</p> <p>Methods</p> <p>We studied a historic cohort of patients with primary lung cancer who underwent intended surgical resection. Patients were grouped according to known postoperative troponin status and survival calculated by Kaplan Meier method and compared using log rank. Parametric survival analysis was used to ascertain independent predictors of mortality.</p> <p>Results</p> <p>From 2001 to 2004, a total of 207 patients underwent lung resection for primary lung cancer of which 14 (7%) were identified with elevated serum troponin levels within 30 days of surgery, with 9 (64%) having classical features of myocardial infarction.</p> <p>The median time to follow up (interquartile range) was 22 (1 to 52) months, and the one and five year survival probabilities (95% CI) for patients without and with postoperative troponin elevation were 92% (85 to 96) versus 60% (31 to 80) and 61% (51 to 71) versus 18% (3 to 43) respectively (p < 0.001).</p> <p>T stage and postoperative troponin elevation remained independent predictors of mortality in the final multivariable model. The acceleration factor for death of elevated serum troponin after adjusting for tumour stage was 9.19 (95% CI 3.75 to 22.54).</p> <p>Conclusion</p> <p>Patients with detected serum troponin elevation are at high risk of early mortality with or without symptoms of myocardial infarction after lung resection.</p> http://www.cardiothoracicsurgery.org/content/1/1/37 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Van Tornout Fillip Mussa Shafi Flaks Lydia Li Choy Li Lim Eric Van Leuven Marc Parry G Wyn |
spellingShingle |
Van Tornout Fillip Mussa Shafi Flaks Lydia Li Choy Li Lim Eric Van Leuven Marc Parry G Wyn Detected troponin elevation is associated with high early mortality after lung resection for cancer Journal of Cardiothoracic Surgery |
author_facet |
Van Tornout Fillip Mussa Shafi Flaks Lydia Li Choy Li Lim Eric Van Leuven Marc Parry G Wyn |
author_sort |
Van Tornout Fillip |
title |
Detected troponin elevation is associated with high early mortality after lung resection for cancer |
title_short |
Detected troponin elevation is associated with high early mortality after lung resection for cancer |
title_full |
Detected troponin elevation is associated with high early mortality after lung resection for cancer |
title_fullStr |
Detected troponin elevation is associated with high early mortality after lung resection for cancer |
title_full_unstemmed |
Detected troponin elevation is associated with high early mortality after lung resection for cancer |
title_sort |
detected troponin elevation is associated with high early mortality after lung resection for cancer |
publisher |
BMC |
series |
Journal of Cardiothoracic Surgery |
issn |
1749-8090 |
publishDate |
2006-10-01 |
description |
<p>Abstract</p> <p>Background</p> <p>Myocardial infarction can be difficult to diagnose after lung surgery. As recent diagnostic criteria emphasize serum cardiac markers (in particular serum troponin) we set out to evaluate its clinical utility and to establish the long term prognostic impact of detected abnormal postoperative troponin levels after lung resection.</p> <p>Methods</p> <p>We studied a historic cohort of patients with primary lung cancer who underwent intended surgical resection. Patients were grouped according to known postoperative troponin status and survival calculated by Kaplan Meier method and compared using log rank. Parametric survival analysis was used to ascertain independent predictors of mortality.</p> <p>Results</p> <p>From 2001 to 2004, a total of 207 patients underwent lung resection for primary lung cancer of which 14 (7%) were identified with elevated serum troponin levels within 30 days of surgery, with 9 (64%) having classical features of myocardial infarction.</p> <p>The median time to follow up (interquartile range) was 22 (1 to 52) months, and the one and five year survival probabilities (95% CI) for patients without and with postoperative troponin elevation were 92% (85 to 96) versus 60% (31 to 80) and 61% (51 to 71) versus 18% (3 to 43) respectively (p < 0.001).</p> <p>T stage and postoperative troponin elevation remained independent predictors of mortality in the final multivariable model. The acceleration factor for death of elevated serum troponin after adjusting for tumour stage was 9.19 (95% CI 3.75 to 22.54).</p> <p>Conclusion</p> <p>Patients with detected serum troponin elevation are at high risk of early mortality with or without symptoms of myocardial infarction after lung resection.</p> |
url |
http://www.cardiothoracicsurgery.org/content/1/1/37 |
work_keys_str_mv |
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