Perioperative Service, 6508Royal Perth Hospital, Perth, Western Australia.
J Perioper Pract. 2021 Jul-Aug;31(7-8):300-305. doi: 10.1177/1750458920930993. Epub 2020 Jul 1.
Myocardial injury after non-cardiac surgery is common and defined as myocardial ischaemia within 30 days after non-cardiac surgery. Diagnosis of myocardial injury after non-cardiac surgery is challenging as this could be clinically asymptomatic during the postoperative period due to many other factors. Role of high-sensitive cardiac troponin in diagnosing myocardial injury after non-cardiac surgery had been evaluated in several studies. Due to the fact that high-sensitive cardiac troponin remains positive for about two weeks in the body and is highly specific in diagnosing clinically silent myocardial injuries, it is recognised as the most useful biomarker in detecting myocardial injury after non-cardiac surgery. However, high-sensitive cardiac troponin is not well incorporated as a biomarker in current major perioperative guidelines or in clinical practice. The aim of this review is to discuss evidence and guidelines in this area in view of the use of high-sensitive cardiac troponin in early identification of myocardial injury after non-cardiac surgery.
非心脏手术后的心肌损伤很常见，定义为非心脏手术后 30 天内的心肌缺血。由于许多其他因素，非心脏手术后心肌损伤的诊断具有挑战性，因为在术后期间可能没有临床症状。几种研究已经评估了高敏心肌肌钙蛋白在诊断非心脏手术后心肌损伤中的作用。由于高敏心肌肌钙蛋白在体内持续阳性约两周，并且在诊断临床无症状性心肌损伤方面具有高度特异性，因此它被认为是检测非心脏手术后心肌损伤的最有用的生物标志物。然而，高敏心肌肌钙蛋白并没有像当前主要围手术期指南或临床实践那样很好地作为生物标志物纳入。本综述的目的是讨论该领域的证据和指南，以了解高敏心肌肌钙蛋白在早期识别非心脏手术后心肌损伤中的作用。
