• Selcuk Adabag, Nicholas Marston, Jorge Brenes, Santiago Garcia, Michael Kuskowski, Steven Santilli, and Edward O McFalls.
• Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN 55417, USA.
• J Crit Care. 2012 Feb 1;27(1):66-72.

BackgroundThe utility of postoperative troponins as an independent predictor of long-term mortality after vascular surgery is unknown.MethodsOne hundred sixty-four consecutive patients underwent vascular surgery and postoperative mortality was determined at 2.5 years. Troponins were drawn within 48 hours postsurgery and the peak levels, defined by the upper reference limit (URL), were categorized as negative (ResultsMortality in the high positive (n = 44), low positive (n = 41), and negative (n = 79) troponin groups was 46%, 17%, and 6%, respectively (P < .05). Independent predictors of long-term mortality were peak postoperative troponins (odds ratio [OR], 8.85; 95% confidence interval [CI], 3.29-23.81; P < .001), tissue loss (OR, 2.87; 95% CI, 1.03-8.00; P = .043), and use of statins (OR, 0.19; 95% CI, 0.07-0.49; P < .001). The c index for peak troponin levels was 0.75 (95% CI, 0.68-0.82; P < .01) and outperformed the Revised Cardiac Risk Index for predicting long-term outcomes.ConclusionsAmong patients undergoing vascular surgery, an elevated postoperative troponin level provides incremental value in predicting long-term outcomes, when compared with standard preoperative cardiac and surgical risks.Published by Elsevier Inc.

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