Before September 2017, around 150 patients from across India who undergo a non-cardiac surgery will be checked for an enzyme that is an indicator of heart attacks, within 30 days of the surgery. The patients — from states such as Maharashtra, Punjab, Kerala and Karnataka — will be part of a large-scale clinical trial spread across 24 countries and sponsored by the Canada-based Population Health Research Foundation.
The clinical trial follows a 2014 study, which found that elevated levels of the Troponin T enzyme after non-cardiac surgeries could predict a Myocardial Infarction (MI) — commonly known as a heart attack —within 30 days of being operated upon. Researchers, including eight from India, termed this correlation ‘Myocardial Injury after Non-cardiac Surgery (MINS)
“The initial study proved that an elevated Troponin T level, independently predicted 30-day mortality in patients over 50,” said Dr Alben Sigamani, associate professor, group head - clinical research, Narayana Health, Bengaluru who is part of the trial.
The study was accepted by the World Heart Federation, which appealed to anaesthetists and cardiologists to check for MINS. “There are no treatments or guidelines available for MINS, but evidence shows that taking a blood-thinner can prevent some of the deaths, both in the short and long-term,” he said.
Currently participants are being recruited to be a part of the study that will test the effects of two drugs which are likely to prevent mortality, cardiac complications and internal bleeding in patients who have suffered MINS.
Dr Ramakant Panda, Chief Consultant for Cardiovascular Thoracic Surgery, Asian Heart Institute said currently, the status of MINS isn’t considered a potential marker for mortality rate amongs patients. “Post-operative follow up procedures, followed in India or abroad, for a non-cardiac patient undergoing surgery don’t include checking cardiac status of the patient. Ideally, considering a number of risk factors involved in the surgery, every person over 40 year of age, should undergo the test to check the cardiac status so that the enzyme levels can be tracked,” said Panda.
The study in figures
Number of patients worldwide: 1,500
Number of patients in India: 150
Number of researchers from India: 8
Number of countries: 24
What is Troponin T?
Troponin T are the proteins, released in the blood when the heart muscle are which is widely known as a myocardial injury. A troponin test measures the levels troponin T or troponin I proteins in the blood. The more damage there is to the heart, the greater the amount of troponin T will be present in the blood. Cardiac troponin T is one of the two most specific and sensitive laboratory markers of myocardial cell injury