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To evaluate the association between troponin levels and 30-day mortality after noncardiac surgery, investigators analyzed data on 15,133 adults aged 45 or older (51.5% women) enrolled in the prospective, international VISION study between August 2007 and January 2011. Using the same assay at all sites, troponin T levels were measured postoperatively at 6 to 12 hours and on days 1, 2, and 3 after surgery. Thirty-day follow-up data were available for 99.7% of the patients, of whom approximately 25% were aged 75 or older.
Overall 30-day mortality was 1.9%, and urgent or emergency surgery was the strongest independent predictor of 30-day mortality. In multivariate analysis, peak troponin levels were independently associated with 30-day mortality…