From creatine kinase-MB to troponin: the adoption of a new standard.

MAJOR perioperative cardiac events in patients undergoing noncardiac surgery continue to be a significant source of perioperative morbidity with ranges from 1.4% in relatively unselected patients to 6% in patients older than 70 yr with cardiac disease. Moreover, perioperative myocardial infarction (PMI) is one of the most important predictors of shortand long-term morbidity and mortality associated with noncardiac surgery. The actual rate of PMI varies between studies in part because of the definition used and the method of surveillance. Part of the definition depends on the biomarkers (e.g., creatine kinase [CK], lactate dehydrogenase, and troponin) used to define PMI. This article will review the evolution in the use of biomarkers and how more specific biomarkers have increased the rate of PMI detected.