An interesting study wae presented at the British Cardiovascular Society (BCS) Conference last year. The study suggested that a high-sensitivity blood test could be used before operations to predict which patients will survive long-term after surgery, and identify those at risk of complications following their operation.

The troponin test is routinely used in Accident and Emergency departments to diagnose a heart attack. The highly accurate test measures blood levels of the molecule troponin, which is released into the bloodstream when heart muscle is injured. However, in this study 10 per cent of patients had raised troponin levels without having suffered from any previous cardiovascular events.

Researchers based at James Cook University Hospital, Middlesbrough, measured the level of troponin in blood samples taken from 993 patients before they underwent elective or emergency surgery. The study looked at patients who had not had a heart attack. A quarter with levels above 50 nanograms per litre (ng/l) died within six months and 37% within a year. In comparison those with lower than 17ng/l, just 2.5% died within six months of surgery and 3.7% within a year.

To see whether inflammation could explain the increase in death rates, the researchers are now testing the blood samples for other signs of inflammation, by checking C-reaction proteins. The link is not yet clear but patients with high troponin levels could have underlying inflammation, researchers said. British Heart Foundation associate medical director Prof Metin Avkiran said if the “underlying causes” could be understood, treatment could be “tailored to improve outcome”.

Professor Metin Avkiran, Associate Medical Director at the British Heart Foundation, said: “If we can understand the underlying causes of heart injury in such patients, their treatment may be tailored to improve outcome after non-cardiac surgery.” Dr Matthew Jackson from Middlesbrough’s James Cook University Hospital said the test could identify patients who needed extra medication, tests and monitoring.