Sayed Masri Syarifah Noor Nazihah, Basri Fadzwani, Yunus Siti Nadzrah, Cheah Saw Kian
Department of Anaesthesiology & Intensive Care, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia.
Department of Anaesthesiology & Intensive Care, Hospital Kuala Lumpur, Kuala Lumpur 50586, Malaysia.
Diagnostics (Basel). 2025 Apr 22;15(9):1061. doi: 10.3390/diagnostics15091061.
A major adverse cardiac event (MACE) following non-cardiac surgery encompasses critical postoperative cardiovascular complications such as myocardial infarction or injury, cardiac arrest, or stroke that are associated with increased perioperative morbidity, mortality, and healthcare resource utilisation. Cardiac troponin (cTn), particularly high-sensitivity cardiac troponin (hs-cTn), has emerged as a key biomarker for prediction of MACE. Despite its recognised utility, there is no consensus on how cTn levels should be used for standardised postoperative surveillance. Interpretation of the cTn levels may vary depending on sex-specific reference values and baseline comorbidities such as chronic kidney disease, sepsis, critical illness, and non-ischaemic conditions. The balance between cost-effectiveness and clinical benefit in implementing universal versus targeted postoperative hs-cTn screening remains to be fully explored. This review examines the prognostic value of cardiac troponin (cTn) levels in predicting major adverse cardiovascular events (MACEs) in patients undergoing non-cardiac surgery, with a focus on perioperative cTn elevations-particularly those associated with myocardial injury after non-cardiac surgery (MINS)-as potential early indicators of increased cardiovascular risk.
非心脏手术后的主要不良心脏事件（MACE）包括严重的术后心血管并发症，如心肌梗死或损伤、心脏骤停或中风，这些并发症与围手术期发病率、死亡率及医疗资源利用增加相关。心肌肌钙蛋白（cTn），尤其是高敏心肌肌钙蛋白（hs-cTn），已成为预测MACE的关键生物标志物。尽管其效用已得到认可，但对于如何将cTn水平用于标准化术后监测尚无共识。cTn水平的解读可能因性别特异性参考值以及慢性肾病、脓毒症、危重病和非缺血性疾病等基线合并症而有所不同。在实施普遍筛查与有针对性的术后hs-cTn筛查之间，成本效益与临床获益的平衡仍有待充分探索。本综述探讨了心肌肌钙蛋白（cTn）水平在预测非心脏手术患者主要不良心血管事件（MACE）方面的预后价值，重点关注围手术期cTn升高，特别是那些与非心脏手术后心肌损伤（MINS）相关的升高，将其作为心血管风险增加的潜在早期指标。
