Prognostic value of high-sensitivity cardiac troponin I early after coronary artery bypass graft surgery.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101265113 Publication Model: Electronic Cited Medium: Internet ISSN: 1749-8090 (Electronic) Linking ISSN: 17498090 NLM ISO Abbreviation: J Cardiothorac Surg Subsets: MEDLINE
    • Publication Information:
      Original Publication: [London] : BioMed Central, 2006-
    • Subject Terms:
      Myocardial Infarction*/etiology ; Troponin I*; Adult ; Female ; Humans ; Male ; Biomarkers ; Coronary Artery Bypass/adverse effects ; Hospital Mortality ; Prognosis ; Prospective Studies ; Retrospective Studies ; Stroke Volume ; Ventricular Function, Left
    • Abstract:
      Background: The diagnosis of periprocedural myocardial infarction (PMI) after coronary artery bypass graft (CABG) is based on biochemical markers along with clinical and instrumental findings. However, there is not a clear cutoff value of high-sensitivity cardiac troponin (hs-cTn) to identify PMI. We hypothesized that isolated hs-cTn concentrations in the first 24 h following CABG could predict cardiac adverse events (in-hospital death and PMI) and/or left ventricular ejection fraction (LVEF) decrease.
      Methods: We retrospectively enrolled all consecutive adult patients undergoing CABG, alone or in association with other cardiac surgery procedures, over 1 year. Hs-cTn I concentrations (Access, Beckman Coulter) were serially measured in the post-operative period and analyzed according to post-operative outcomes.
      Results: 300 patients were enrolled; 71.3% underwent CABG alone, 33.7% for acute coronary syndrome. Most patients showed hs-cTn I values superior to the limit required by the latest guidelines for the diagnosis of PMI. Five patients (1.7%) died, 8% developed a PMI, 10.6% showed a LVEF decrease ≥ 10%. Hs-cTn I concentrations did not significantly differ with respect to death and/or PMI whereas they were associated with LVEF decrease ≥ 10% (p value < 0.005 at any time interval), in particular hs-cTn I values at 9-12 h post-operatively. A hs-cTn I cutoff of 5556 ng/L, a value 281 (for males) and 479 (for females) times higher than the URL, at 9-12 h post-operatively was identified, representing the best balance between sensitivity (55%) and specificity (79%) in predicting LVEF decrease ≥ 10%.
      Conclusions: Hs-cTn I at 9-12 h post-CABG may be useful to early identify patients at risk for LVEF decrease and to guide early investigation and management of possible post-operative complications.
      (© 2022. The Author(s).)
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    • Contributed Indexing:
      Keywords: Coronary artery bypass graft; High-sensitivity cardiac troponin I; Left ventricular ejection fraction; Periprocedural myocardial infarction
    • Accession Number:
      0 (Biomarkers)
      0 (Troponin I)
    • Publication Date:
      Date Created: 20221102 Date Completed: 20221216 Latest Revision: 20221216
    • Publication Date:
      20231215
    • Accession Number:
      PMC9628166
    • Accession Number:
      10.1186/s13019-022-02027-x
    • Accession Number:
      36319986