Are high-sensitivity cardiac troponin I values stable between preoperative visit and day of non-cardiac surgery?

Background: It is unclear if cardiac troponin values are stable in patients prior to undergoing non-cardiac surgery, or if they tend to rise towards the day of surgery.

Methods: In this small pilot study (n=18) among patients with cardiac risk undergoing non-cardiac surgery, we determined if high-sensitivity cardiac troponin I (hscTnI) changes between the preoperative clinic visit and the day of surgery. HscTnI was measured on an Abbott Architect STAT (Abbott Laboratories, USA) platform.

Results: The mean duration between preoperative clinic visit and day of surgery was 8.7±2.8 (SD) days. Median hscTnI was 3.4ng/L [2.0-4.8, IQR] at the preoperative visit and 2.8ng/L [2.3-4.4] on the day of surgery (mean difference-0.24ng/L, 95% CI - 0.73 to 0.24ng/L, p=0.30). Only one patient had a large change (>50%) along with symptoms.

Discussion: Evidence from this small study suggests that cardiac troponin values are stable in most high-risk patients, absent clinical events, within 10days prior to non-cardiac surgery.