ESAIC focused guideline for the use of cardiac biomarkers in perioperative risk evaluation

In recent years, there has been increasing focus on the use of cardiac biomarkers in patients undergoing noncardiac surgery. The aim of this focused guideline was to provide updated guidance regarding the pre-, post- and combined pre-and postoperative use of cardiac troponin and B-type natriuretic p...

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Bibliographic Details
Published in:	European journal of anaesthesiology Vol. 40; no. 12; pp. 888 - 927
Main Authors:	Lurati Buse, Giovanna, Bollen Pinto, Bernardo, Abelha, Fernando, Abbott, Tom E.F., Ackland, Gareth, Afshari, Arash, De Hert, Stefan, Fellahi, Jean-Luc, Giossi, Laure, Kavsak, Peter, Longrois, Dan, M’Pembele, Rene, Nucaro, Anthony, Popova, Ekaterine, Puelacher, Christian, Richards, Toby, Roth, Sebastian, Sheka, Mootii, Szczeklik, Wojciech, van Waes, Judith, Walder, Bernhard, Chew, Michelle S.
Format:	Journal Article
Language:	English
Published:	England Lippincott Williams & Wilkins 01-12-2023 Lippincott, Williams & Wilkins
Subjects:	Adult Biomarkers Health Status Disparities Humans Life Sciences Natriuretic Peptide, Brain Postoperative Period Troponin Brain Troponin Health Status Disparities Humans Postoperative Period Biomarkers Adult Natriuretic Peptide
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Summary:	In recent years, there has been increasing focus on the use of cardiac biomarkers in patients undergoing noncardiac surgery. The aim of this focused guideline was to provide updated guidance regarding the pre-, post- and combined pre-and postoperative use of cardiac troponin and B-type natriuretic peptides in adult patients undergoing noncardiac surgery. The guidelines were prepared using Grading of Recommendations Assessment Development and Evaluation (GRADE) methodology. This included the definition of critical outcomes, a systematic literature search, appraisal of certainty of evidence, evaluation of biomarker measurement in terms of the balance of desirable and undesirable effects including clinical outcomes, resource use, health inequality, stakeholder acceptance, and implementation. The panel differentiated between three different scopes of applications: cardiac biomarkers as prognostic factors, as tools for risk prediction, and for biomarker-enhanced management strategies. In a modified Delphi process, the task force defined 12 critical outcomes. The systematic literature search resulted in over 25,000 hits, of which 115 full-text articles formed the body of evidence for recommendations. The evidence appraisal indicated heterogeneity in the certainty of evidence across critical outcomes. Further, there was relevant gradient in the certainty of evidence across the three scopes of application. Recommendations were issued and if this was not possible due to limited evidence, clinical practice statements were produced. The ESAIC focused guidelines provide guidance on the perioperative use of cardiac troponin and B-type natriuretic peptides in patients undergoing noncardiac surgery, for three different scopes of application.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0265-0215 1365-2346 1365-2346
DOI:	10.1097/EJA.0000000000001865