Association Between Perioperative Troponin Management and Major Adverse Cardiac Events in Elderly Patients with Colorectal Cancer
10.11714/jsysu.med.YX20260016
- VernacularTitle:围术期肌钙蛋白管理对老年结直肠肿瘤患者心脏事件发生的关联
- Author:
Xue LOU
1
;
Chuyi ZHANG
2
;
Jiaojie XUE
1
;
Zhichong CHEN
1
;
Shiyao CHENG
1
;
Weijie ZENG
1
;
Mao OUYANG
1
Author Information
1. Department of Cardiology， The Sixth Affiliated Hospital， Sun Yat-sen University， Guangzhou 510655， China
2. Department of Anaesthesia， The Sixth Affiliated Hospital， Sun Yat-sen University， Guangzhou 510655， China
- Publication Type:Journal Article
- Keywords:
elderly colorectal cancer;
perioperative period;
troponin;
major adverse cardiac events;
risk management
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2026;47(4):594-600
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the association between perioperative troponin elevation and the occurrence of major adverse cardiac events （MACE） in elderly patients with colorectal cancer， and to provide evidence for optimizing perioperative management strategies. MethodsA total of 268 elderly patients aged 70 years and above who underwent colorectal cancer surgery were retrospectively enrolled. They were divided into a conventional management group （87 cases） and a standardized management group （181 cases） according to the perioperative management strategy. Binary logistic regression analysis was used to identify the independent influencing factors for the occurrence of major adverse cardiac events. P-value ≤ 0.05 was considered statistically significant. ResultsAmong the 268 patients， the overall incidence of perioperative major adverse cardiac events was 4.5% （12/268）. The total incidence of major adverse cardiac events in the conventional management group was 8.0% （7/87）， which was significantly higher than that in the standardized management group （2.8%， 5/181；P=0.05）. Specifically， the incidences of myocardial infarction， heart failure， and death in the conventional management group were markedly higher than those in the standardized management group （8.0% vs. 2.2%， 4.6% vs. 0.6%， 4.6% vs. 0.6%， all P＜0.05）， while no significant difference was observed in the incidence of cardiogenic shock between the two groups （1.1% vs. 1.1%， P＞0.05）. Postoperative troponin elevation was significantly associated with the occurrence of perioperative major adverse cardiac events except for cardiogenic shock （including total cardiovascular events， myocardial infarction， heart failure， and death） （all P＜0.05）， and it was identified as a strong independent risk factor for perioperative major adverse cardiac events in these patients. ConclusionCompared with conventional management， standardized perioperative troponin management can significantly reduce the risks of myocardial infarction， heart failure， and death， and also exhibits a potential protective trend against cardiogenic shock. Postoperative troponin elevation is a strong independent risk factor for the occurrence of perioperative major adverse cardiac events.
