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After lung resection, troponin elevation may be regulated by mechanisms other than myocardial ischemia. Perioperative natriuretic peptides measurement may help identify changes in ventricular function during thoracic surgery. Integrating both cardiac biomarkers may improve the predictive value for cardiovascular complications after lung resection.
Objectives: To evaluate the incidence and magnitude of perioperative N-terminal pro brain natriuretic peptide (NT-proBNP) and high-sensitivity troponin I (Tn I) elevation in patients undergoing pulmonary resection and its predictive value for cardiovascular complications. Methodology: Prospective, multicenter, observational cohort study in patients >45 years undergoing elective thoracic surgery for lung resection. Cardiac biomarkers Tn I and NT-proBNP will be measured preoperatively and at postoperative days 1 and 2. Risk score for major cardiovascular postoperative complications will be calculated depending of both biomarkers perioperative changes.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| serum high-sensitivity Troponin I (TnI) and NT-Pro-Brain Natriuretic Peptide (NT-proBNP) | Diagnostic Test | Both biomarkers will be determined in each patient preoperatively and at postoperative day 1 and day 2.Measurements will not necessarily be taken independently of other measurements, meaning that the addition of the biomarker could be included in routine pre or postoperative day-1 and day 2 blood tests. |
| Measure | Description | Time Frame |
|---|---|---|
| NT-proBNP perioperative changes | Perioperative change in NT-Pro-Brain Natriuretic Peptide (NT-proBNP) levels in patients undergoing pulmonary resection. Cutt-of values will be NT-proBNP ≥ 300 pg/ml pg/ml | Change from baseline NT-proBNP at two-days after surgery |
| TnI perioperative changes | Perioperative changes in high-sensitivity troponin I (TnI) levels in patients undergoing pulmonary resection. Cutt-of values will be TnI ≥45 ng/L | Change from baseline TnI at two-days after surgery |
| Major cardiovascular complications | Postoperative non-fatal cardiac arrest, acute myocardial infarction, angina, congestive heart failure, new clinically relevant cardiac arrhythmia, cardiovascular death | 30-days after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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Adulty patients undergoing elective thoracic and lung resection surgery: neumonectomy, lobectomy, bilobectomy or segmentectomy
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Universitari Vall d'Hebron | Barcelona | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41997702 | Derived | Alonso M, Popova E, De Miguel M, Garcia-Osuna A, Gonzalez-Tallada A, Ordonez-Llanos J, Jauregui A, Trujillo JC, Martin Grande A, Martinez-Tellez E, Parera A, Planas G, Trujillo L, Butron D, Sola-Roca J, De Nadal M. N-terminal proBNP adds prognostic value to high-sensitivity cardiac troponin I in elective thoracic surgery: an observational cohort study. BMJ Open. 2026 Apr 17;16(4):e108073. doi: 10.1136/bmjopen-2025-108073. | |
| 36600389 |
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| ID | Term |
|---|---|
| D003324 | Coronary Artery Disease |
| D011183 | Postoperative Complications |
| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| Derived |
| Alonso M, Popova E, Martin-Grande A, Perez-Velez J, Trujillo JC, Gajate L, de Miguel M, Gonzalez-Tallada A, Martinez-Tellez E, Cladellas-Gutierrez E, Planas G, de Pablo A, Parise D, Candela-Toha A, de Nadal M. Study protocol for an observational cohort evaluating incidence and clinical relevance of perioperative elevation of high-sensitivity troponin I and N-terminal pro-brain natriuretic peptide in patients undergoing lung resection. BMJ Open. 2022 Dec 8;12(12):e063778. doi: 10.1136/bmjopen-2022-063778. |
| D001161 |
| Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |