{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:04:33Z","timestamp":1789535073520,"version":"build-2803163510"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,9,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Preoperative hs\u2010TnT (high\u2010sensitivity cardiac troponin T) and NT\u2010proBNP (N\u2010terminal pro\u2010B\u2010type natriuretic peptide) are used for risk prediction in noncardiac surgery. While the European Society of Cardiology recommends hs\u2010TnT, American Cardiology and European anesthesiology societies support NT\u2010proBNP. Direct comparisons of their predictive performance are limited. This study compares preoperative hs\u2010TnT and NT\u2010proBNP in predicting cardiac events after noncardiac surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This secondary analysis pooled data from the METREPAIR (Metabolic Equivalents: Reevaluation for Perioperative Cardiac Risk) and MINSS (Myocardial Injury in Noncardiac Surgery in Sweden) studies involving patients with elevated cardiovascular risk undergoing elective noncardiac surgery. The primary end point was the incidence of 30\u2010day major adverse cardiovascular events, with 30\u2010day death as the secondary end point. Logistic regression models, including Revised Cardiac Risk Index (RCRI) and age, were augmented by biomarkers. Prediction was assessed using area under the receiver operating characteristic curve, calibration slopes, and Brier scores. Decision curve analysis was conducted at predefined thresholds for major adverse cardiovascular events and death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 2251 patients, MACE occurred in 5.8% (131\/2251) and death in 1.6% (37\/2251). Both biomarkers were significantly associated with outcomes. Only hs\u2010TnT improved discrimination for predicting death (area under the receiver operating characteristic curve\n                      <jats:sub>RCRI+age+hsTnT<\/jats:sub>\n                      =0.680 versus area under the receiver operating characteristic curve\n                      <jats:sub>RCRI+age<\/jats:sub>\n                      =0.674; \u0394 area under the curve: 0.006;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.047). Brier scores and calibration slopes showed good calibration for all models. Benefit equivalents of RCRI+hs\u2010TnT versus RCRI+NT\u2010proBNP were \u22120.06 per 1000 and \u22120.17 per 1000 for major adverse cardiovascular events and +0.06 per 1000 versus \u20130.08 per 1000 (5% threshold) and \u22120.35 per 1000 versus \u20130.06 per 1000 (10% threshold) for death. A literature review did not suggest differences between biomarkers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Hs\u2010TnT and NT\u2010proBNP were associated with major adverse cardiovascular events and death, but their contribution to risk prediction over RCRI and age was limited. No significant difference was found between biomarkers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.050032","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:54:00Z","timestamp":1788965640000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of High\u2010Sensitivity Troponin T Versus N\u2010Terminal Pro\u2010B\u2010Type Natriuretic Peptide for Prediction of Major Adverse Cardiovascular Events After Noncardiac Surgery"],"prefix":"10.1161","volume":"15","author":[{"given":"Anna","family":"Kirkopoulos","sequence":"first","affiliation":[{"name":"Medical Faculty and University Hospital D\u00fcsseldorf, Heinrich\u2010Heine\u2010University D\u00fcsseldorf","place":["D\u00fcsseldorf, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Larmann","sequence":"additional","affiliation":[{"name":"Heidelberg University Hospital","place":["Heidelberg, Germany"]},{"name":"University Hospital Rheinisch\u2013Westfaelische Technische Hochschule (RWTH) Aachen","place":["Aachen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1178-3701","authenticated-orcid":false,"given":"Hans\u2010Joerg","family":"Gillmann","sequence":"additional","affiliation":[{"name":"Hannover Medical School","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7499-3331","authenticated-orcid":false,"given":"Ren\u00e9","family":"M'Pembele","sequence":"additional","affiliation":[{"name":"Medical Faculty and University Hospital D\u00fcsseldorf, Heinrich\u2010Heine\u2010University D\u00fcsseldorf","place":["D\u00fcsseldorf, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlad\u2010Ionut","family":"Bucur\u2010Cristescu","sequence":"additional","affiliation":[{"name":"Medical Faculty and University Hospital D\u00fcsseldorf, Heinrich\u2010Heine\u2010University D\u00fcsseldorf","place":["D\u00fcsseldorf, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9529-2461","authenticated-orcid":false,"given":"Theresa","family":"Tenge","sequence":"additional","affiliation":[{"name":"Medical Faculty and University Hospital D\u00fcsseldorf, Heinrich\u2010Heine\u2010University D\u00fcsseldorf","place":["D\u00fcsseldorf, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8325-4797","authenticated-orcid":false,"given":"Judith","family":"van Waes","sequence":"additional","affiliation":[{"name":"University Medical Center Utrecht","place":["Utrecht, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Roth","sequence":"additional","affiliation":[{"name":"Medical Faculty and University Hospital D\u00fcsseldorf, 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