Anesthesiology and Pain Medicine

Published by: Kowsar

Perioperative Cardiac Troponin I Levels in Patients Undergoing Total Hip and Total Knee Arthroplasty: A Single Center Study

Mir Mohammad Taghi Mortazavi 1 , Jafar Ganjpour Sales 2 , Masoud Nouri-Vaskeh 3 , 4 , * , Masoud Parish 1 , ** and Salar Abdolhosseynzadeh 5
Authors Information
1 Department of Anesthesiology and Critical Care, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
2 Department of Orthopedics Surgery, Shohada Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
3 Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
4 Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
5 Tabriz University of Medical Sciences, Tabriz, Iran
Corresponding Authors:
Article information
  • Anesthesiology and Pain Medicine: December 31, 2018, 8 (6); e84228
  • Published Online: November 19, 2018
  • Article Type: Research Article
  • Received: September 12, 2018
  • Revised: October 20, 2018
  • Accepted: November 10, 2018
  • DOI: 10.5812/aapm.84228

To Cite: Mortazavi M M T , Ganjpour Sales J, Nouri-Vaskeh M, Parish M, Abdolhosseynzadeh S. Perioperative Cardiac Troponin I Levels in Patients Undergoing Total Hip and Total Knee Arthroplasty: A Single Center Study, Anesth Pain Med. 2018 ; 8(6):e84228. doi: 10.5812/aapm.84228.

Copyright © 2018, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Methods
3. Results
4. Discussion
  • 1. Cram P, Lu X, Kates SL, Singh JA, Li Y, Wolf BR. Total knee arthroplasty volume, utilization, and outcomes among medicare beneficiaries, 1991-2010. JAMA. 2012;308(12):1227-36. doi: 10.1001/2012.jama.11153. [PubMed: 23011713]. [PubMed Central: PMC4169369].
  • 2. Rahimzadeh P, Imani F, Sayarifard A, Sayarifard S, Faiz SH. Ultrasound-guided fascia iliaca compartment block in orthopedic fractures: Bupivacaine 0.2% or 0.3%? Med J Islam Repub Iran. 2016;30:433. [PubMed: 28210598]. [PubMed Central: PMC5307510].
  • 3. Guimaraes-Pereira L, Valdoleiros I, Reis P, Abelha F. Evaluating persistent postoperative pain in one tertiary hospital: Incidence, quality of life, associated factors, and treatment. Anesth Pain Med. 2016;6(2). e36461. doi: 10.5812/aapm.36461. [PubMed: 27252908]. [PubMed Central: PMC4886451].
  • 4. Rahimzadeh P, Imani F, Faiz SHR, Entezary SR, Zamanabadi MN, Alebouyeh MR. The effects of injecting intra-articular platelet-rich plasma or prolotherapy on pain score and function in knee osteoarthritis. Clin Interv Aging. 2018;13:73-9. doi: 10.2147/CIA.S147757. [PubMed: 29379278]. [PubMed Central: PMC5757490].
  • 5. Lee KH, Kim JY, Kim JW, Park JS, Lee KW, Jeon SY. Influence of ketamine on early postoperative cognitive function after orthopedic surgery in elderly patients. Anesth Pain Med. 2015;5(5). e28844. doi: 10.5812/aapm.28844. [PubMed: 26587403]. [PubMed Central: PMC4644306].
  • 6. Viola J, Gomez MM, Restrepo C, Maltenfort MG, Parvizi J. Preoperative anemia increases postoperative complications and mortality following total joint arthroplasty. J Arthroplasty. 2015;30(5):846-8. doi: 10.1016/j.arth.2014.12.026. [PubMed: 25669131].
  • 7. Menendez ME, Memtsoudis SG, Opperer M, Boettner F, Gonzalez Della Valle A. A nationwide analysis of risk factors for in-hospital myocardial infarction after total joint arthroplasty. Int Orthop. 2015;39(4):777-86. doi: 10.1007/s00264-014-2502-z. [PubMed: 25172363].
  • 8. Puelacher C, Lurati Buse G, Seeberger D, Sazgary L, Marbot S, Lampart A, et al. Perioperative myocardial injury after noncardiac surgery: Incidence, mortality, and characterization. Circulation. 2018;137(12):1221-32. doi: 10.1161/CIRCULATIONAHA.117.030114. [PubMed: 29203498].
  • 9. Shah AS, Anand A, Sandoval Y, Lee KK, Smith SW, Adamson PD, et al. High-sensitivity cardiac troponin I at presentation in patients with suspected acute coronary syndrome: A cohort study. Lancet. 2015;386(10012):2481-8. doi: 10.1016/S0140-6736(15)00391-8. [PubMed: 26454362]. [PubMed Central: PMC4765710].
  • 10. Masson S, Latini R, Mureddu GF, Agabiti N, Miceli M, Cesaroni G, et al. High-sensitivity cardiac troponin T for detection of subtle abnormalities of cardiac phenotype in a general population of elderly individuals. J Intern Med. 2013;273(3):306-17. doi: 10.1111/joim.12023. [PubMed: 23216903].
  • 11. Oberweis BS, Nukala S, Rosenberg A, Guo Y, Stuchin S, Radford MJ, et al. Thrombotic and bleeding complications after orthopedic surgery. Am Heart J. 2013;165(3):427-33 e1. doi: 10.1016/j.ahj.2012.11.005. [PubMed: 23453114]. [PubMed Central: PMC3595114].
  • 12. Shanmugam NR, Muthukumar S, Tanak AS, Prasad S. Multiplexed electrochemical detection of three cardiac biomarkers cTnI, cTnT and BNP using nanostructured ZnO-sensing platform. Future Cardiol. 2018;14(2):131-41. doi: 10.2217/fca-2017-0074. [PubMed: 29388803].
  • 13. Lindert S, Cheng Y, Kekenes-Huskey P, Regnier M, McCammon JA. Effects of HCM cTnI mutation R145G on troponin structure and modulation by PKA phosphorylation elucidated by molecular dynamics simulations. Biophys J. 2015;108(2):395-407. doi: 10.1016/j.bpj.2014.11.3461. [PubMed: 25606687]. [PubMed Central: PMC4302190].
  • 14. Apple FS, Collinson PO; Ifcc Task Force on Clinical Applications of Cardiac Biomarkers. Analytical characteristics of high-sensitivity cardiac troponin assays. Clin Chem. 2012;58(1):54-61. doi: 10.1373/clinchem.2011.165795. [PubMed: 21965555].
  • 15. Agewall S, Giannitsis E, Jernberg T, Katus H. Troponin elevation in coronary vs. non-coronary disease. Eur Heart J. 2011;32(4):404-11. doi: 10.1093/eurheartj/ehq456. [PubMed: 21169615].
  • 16. Chang CB, Yoo JH, Koh IJ, Kang YG, Seong SC, Kim TK. Key factors in determining surgical timing of total knee arthroplasty in osteoarthritic patients: age, radiographic severity, and symptomatic severity. J Orthop Traumatol. 2010;11(1):21-7. doi: 10.1007/s10195-010-0086-y. [PubMed: 20169392]. [PubMed Central: PMC2837816].
  • 17. Dreinhofer KE, Dieppe P, Sturmer T, Grober-Gratz D, Floren M, Gunther KP, et al. Indications for total hip replacement: Comparison of assessments of orthopaedic surgeons and referring physicians. Ann Rheum Dis. 2006;65(10):1346-50. doi: 10.1136/ard.2005.047811. [PubMed: 16439438]. [PubMed Central: PMC1798326].
  • 18. Gibler WB, Young GP, Hedges JR, Lewis LM, Smith MS, Carleton SC, et al. Acute myocardial infarction in chest pain patients with nondiagnostic ECGs: Serial CK-MB sampling in the emergency department. The Emergency Medicine Cardiac Research Group. Ann Emerg Med. 1992;21(5):504-12. [PubMed: 1570904].
  • 19. Gibler WB, Lewis LM, Erb RE, Makens PK, Kaplan BC, Vaughn RH, et al. Early detection of acute myocardial infarction in patients presenting with chest pain and nondiagnostic ECGs: Serial CK-MB sampling in the emergency department. Ann Emerg Med. 1990;19(12):1359-66. [PubMed: 2240745].
  • 20. O'Donnell MJ, Chin SL, Rangarajan S, Xavier D, Liu L, Zhang H, et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): A case-control study. Lancet. 2016;388(10046):761-75. doi: 10.1016/S0140-6736(16)30506-2. [PubMed: 27431356].
  • 21. Urban MK, Jules-Elysee K, Loughlin C, Kelsey W, Flynn E. The one year incidence of postoperative myocardial infarction in an orthopedic population. HSS J. 2008;4(1):76-80. doi: 10.1007/s11420-007-9070-3. [PubMed: 18751868]. [PubMed Central: PMC2504276].
  • 22. Jules-Elysee K, Urban MK, Urquhart B, Milman S. Troponin I as a diagnostic marker of a perioperative myocardial infarction in the orthopedic population. J Clin Anesth. 2001;13(8):556-60. [PubMed: 11755323].
  • 23. Ausset S, Auroy Y, Lambert E, Vest P, Plotton C, Rigal S, et al. Cardiac troponin I release after hip surgery correlates with poor long-term cardiac outcome. Eur J Anaesthesiol. 2008;25(2):158-64. doi: 10.1017/S0265021507001202. [PubMed: 17666156].
  • 24. Chong CP, Lam QT, Ryan JE, Sinnappu RN, Lim WK. Incidence of post-operative troponin I rises and 1-year mortality after emergency orthopaedic surgery in older patients. Age Ageing. 2009;38(2):168-74. doi: 10.1093/ageing/afn231. [PubMed: 19008306].
  • 25. Chong CP, van Gaal WJ, Profitis K, Ryan JE, Savige J, Lim WK. Electrocardiograph changes, troponin levels and cardiac complications after orthopaedic surgery. Ann Acad Med Singapore. 2013;42(1):24-32. [PubMed: 23417588].
  • 26. Urban MK, Wolfe SW, Sanghavi NM, Fields K, Magid SK. The incidence of perioperative cardiac events after orthopedic surgery: A single institutional experience of cases performed over one year. HSS J. 2017;13(3):248-54. doi: 10.1007/s11420-017-9561-9. [PubMed: 28983217]. [PubMed Central: PMC5617821].
  • 27. Jeremias A, Gibson CM. Narrative review: Alternative causes for elevated cardiac troponin levels when acute coronary syndromes are excluded. Ann Intern Med. 2005;142(9):786-91. [PubMed: 15867411].
  • 28. White HD. Pathobiology of troponin elevations: Do elevations occur with myocardial ischemia as well as necrosis? J Am Coll Cardiol. 2011;57(24):2406-8. doi: 10.1016/j.jacc.2011.01.029. [PubMed: 21658560].
  • 29. Landesberg G, Jaffe AS, Gilon D, Levin PD, Goodman S, Abu-Baih A, et al. Troponin elevation in severe sepsis and septic shock: The role of left ventricular diastolic dysfunction and right ventricular dilatation*. Crit Care Med. 2014;42(4):790-800. doi: 10.1097/CCM.0000000000000107. [PubMed: 24365861].
  • 30. Tanindi A, Cemri M. Troponin elevation in conditions other than acute coronary syndromes. Vasc Health Risk Manag. 2011;7:597-603. doi: 10.2147/VHRM.S24509. [PubMed: 22102783]. [PubMed Central: PMC3212425].
  • 31. Ong P, Athanasiadis A, Hill S, Vogelsberg H, Voehringer M, Sechtem U. Coronary artery spasm as a frequent cause of acute coronary syndrome: The CASPAR (coronary artery spasm in patients with acute coronary syndrome) study. J Am Coll Cardiol. 2008;52(7):523-7. doi: 10.1016/j.jacc.2008.04.050. [PubMed: 18687244].
  • 32. Scheitz JF, Mochmann HC, Witzenbichler B, Fiebach JB, Audebert HJ, Nolte CH. Takotsubo cardiomyopathy following ischemic stroke: A cause of troponin elevation. J Neurol. 2012;259(1):188-90. doi: 10.1007/s00415-011-6139-1. [PubMed: 21681632].
  • 33. Lim W, Whitlock R, Khera V, Devereaux PJ, Tkaczyk A, Heels-Ansdell D, et al. Etiology of troponin elevation in critically ill patients. J Crit Care. 2010;25(2):322-8. doi: 10.1016/j.jcrc.2009.07.002. [PubMed: 19781898].
  • 34. Patil H, Vaidya O, Bogart D. A review of causes and systemic approach to cardiac troponin elevation. Clin Cardiol. 2011;34(12):723-8. doi: 10.1002/clc.20983. [PubMed: 22120679].
  • 35. Lee MJ, Park YS, Ahn S, Sohn CH, Seo DW, Lee JH, et al. [Clinical features of acute aortic dissection patients initially diagnosed with ST-segment elevation myocardial infarction]. J Korea Soci Emergency Med. 2016;27(1):30-5. Korean.
  • 36. Meigher S, Thode HC, Peacock WF, Bock JL, Gruberg L, Singer AJ. Causes of elevated cardiac troponins in the emergency department and their associated mortality. Acad Emerg Med. 2016;23(11):1267-73. doi: 10.1111/acem.13033. [PubMed: 27320126].
  • 37. Eggers KM, Lind L, Ahlstrom H, Bjerner T, Ebeling Barbier C, Larsson A, et al. Prevalence and pathophysiological mechanisms of elevated cardiac troponin I levels in a population-based sample of elderly subjects. Eur Heart J. 2008;29(18):2252-8. doi: 10.1093/eurheartj/ehn327. [PubMed: 18606612].
Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments