Isolated cardiac troponin rise does not modify the prognosis in elderly patients with hip fracture

Perioperative myocardial infarction remains a frequent and life-threatening complication in noncardiac surgery.[1–3] In 2012, redefinition of acute myocardial infarction highlighted the importance of troponin elevation in association with either electrocardiographic changes, and/or clinical symptoms of ischemia, and/or new wall motion anomalies.[4] However, large database analyses have recently extended the concept of perioperative myocardial infarction to myocardial injury after noncardiac surgery because even subtle and isolated increase in troponin irrespective of ischemic features (i.e., ischemic symptoms and electrocardiogram [ECG] findings) is associated with a significant mortality risk.[5,6] This result is in agreement with previous studies showing that isolated troponin rise (ITR) is associated with an increased mortality risk in various nonischemic conditions such as sepsis,[7] pulmonary embolism,[8] renal failure,[9] and acute respiratory failure in chronic obstructive pulmonary disease patient.[10]