Roche’s Elecsys® Troponin T assay helps to predict mortality following noncardiac surgery

New results from the VISION Study show short-term risk assessment of cardiac events

Monitoring postoperative troponin T measurements can enhance risk stratification after noncardiac surgery and help physicians identify which patients will require more intensive monitoring and management. The large international Vascular events In noncardiac Surgery patIents cOhort evaluatioN (VISION) Study by the McMaster University has shown the Elecsys Troponin T assay from Roche to improve prediction of 30-day mortality in patients following noncardiac surgery. Now published in The Journal of the American Medical Association (JAMA)1, these findings will help health professionals to assess the short-term risk to individual patients and tailor their monitoring, treatment and management accordingly to reduce the post-operative mortality risk.

Of the 200 million adults worldwide who undergo noncardiac surgery each year, more than 1 million die within 30 days. Current preoperative risk prediction models have a limited ability to predict mortality. The VISION team aimed at improving risk prediction utilizing the 4th-generation Elecsys Troponin T assay to measure troponin T (TnT) levels in patients after noncardiac surgery. The results revealed a correlation between higher peak TnT levels and increased 30-day mortality.

The release of the protein TnT occurs only after cardiac damage, but little is known about interpreting TnT levels in patients following noncardiac surgery.

The VISION Study used the 4th generation Elecsys Troponin T assay from Roche to accurately analyze blood samples from patients who had undergone noncardiac inpatient surgery. The team measured TnT levels in patients 6–12 hours after surgery and on days 1, 2, and 3 after surgery to determine if there was a link between peak TnT levels and 30-day mortality. The VISION Study demonstrates that measuring TnT levels in the first 3 days after noncardiac surgery substantially improves risk prediction and reduces the possibility of misdiagnosis or missed diagnosis of complications. Specifically, the study demonstrated that higher peak TnT levels are associated with a significantly greater risk of 30-day mortality. Moreover, 1.9% of patients died within 30 days after surgery, and of these 26.6% died after discharge from hospital.

About the VISION Study

The VISION Study is the largest international prospective cohort study evaluating complications after surgery of more than 40,000 noncardiac surgery patients. The study has been conducted by the McMaster University research team of Dr. P.J. Devereaux, VISION principal investigator and associate professor of medicine in Hamilton/Canada. The current findings from the first 15’133 patients from North and South America, Asia, Australia, and Europe have been published in the 6th of June 2012 edition of The Journal of the American Medical Association (JAMA). The study has substantial potential to change how patients are monitored after surgery. Some of the major funders include the Canadian Institutes of Health Research and the Heart and Stroke Foundation of Ontario.

Reference:

1) P.J. Devereaux et al. Association Between Postoperative Troponin Levels and 30-Day Mortality Among Patients Undergoing Noncardiac Surgery. In: JAMA, June 6, 2012—Vol 307, No. 21, p. 2295 ff.

About Roche

Headquartered in Basel, Switzerland, Roche is a leader in research-focused healthcare with combined strengths in pharmaceuticals and diagnostics. Roche is the world’s largest biotech company with truly differentiated medicines in oncology, virology, inflammation, metabolism and CNS. Roche is also the world leader in in-vitro diagnostics, tissue-based cancer diagnostics and a pioneer in diabetes management. Roche’s personalized healthcare strategy aims at providing medicines and diagnostic tools that enable tangible improvements in the health, quality of life and survival of patients. In 2011, Roche had over 80,000 employees worldwide and invested over 8 billion Swiss francs in R&D. The Group posted sales of 42.5 billion Swiss francs. Genentech, United States, is a wholly owned member of the Roche Group. Roche has a majority stake in Chugai Pharmaceutical, Japan. For more information: www.roche.com.

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