Cardiac troponin I levels after cardiac surgery as predictor for in-hospital mortality☆

Geene, Yvette van; Swieten, Henri A. van; Noyez, Luc

doi:10.1510/icvts.2009.216408

Cited by 28 publications

(24 citation statements)

References 16 publications

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“…Cardiac Troponin I (cTnI) was defined as a marker of myocardial injury, which has reported to be superior insensitivity and specificity when compared with habitual biomarkers, such as creatine kinase and myoglobin [19]. However, it can be affected by the iatrogenic stressors of CABG and is not typically associated with permanent myocardial injury [20].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, Salamonsen et al suggested that a single cTnI measurement 24 hours after CABG can be beneficial for identifying adverse outcomes with high efficacy and simplicity [21]. van Geene et al reported that higher postoperative cTnI levels are associated with an increased risk of hospital mortality after cardiac surgery [19]. Selvanayagam et al reported lower postoperative cTnI levels and better left ventricular function after early periods of off-pump surgery, when compared with the on-pump technique [22].…”

Section: Discussionmentioning

confidence: 99%

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The Comparison of Clinical and Biochemical Outcomes in Off-Pump and Conventional Coronary Artery Bypass Grafting Surgery

Temizturk¹,

Azboy²,

Karapinar³

et al. 2015

OALib

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Objective: There is no common concencus the clinical results of coronary artery bypass grafting (CABG) surgery patients who underwent off-pump or conventional techniques. Our aim of this study was to compare the changes of myocardial functions, patients' clinical results, biochemical marker release during surgery and postoperatively in On-and Off-Pump CABG surgery. Method: A consecutive series of 50 coronary artery disease (CAD) patients who underwent elective CABG surgery included for this study. The patients were divided into two groups (Group 1, N = 25 and group 2, N = 25). Demographic data including the patients' age, gender, body mass index (BMI), diseased coronary artery numbers, LVEF were similar. Postoperative red package blood cell, fresh frozen plasma, and thrombocyte requirements were high in On-Pump group (p < 0.05). But there was not any significant difference when compared the number of unexpected surgery because of mediastinal bleeding after operations in both groups. Preoperative and postoperative N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP), cardiac Troponin-I (cTnI) levels during and after surgery, and left ventricular ejection fractions (LVEF) prior to discharge from hospital were compared. Results: There were no statistical significancy when compared postoperative mortality and morbidity. The operations time was low in off-pump group (p < 0.05). The NT-proBNP levels were similar in both groups (p > 0.05). However, cTnI levels were significantly higher in the on-pump group (p = 0.0001). Postoperative LVEF decreased significantly in both groups when compared to preoperative echocardiography examinations (p = 0.001). But the changes of postoperative LVEFs in both groups were not statistical significant (p > 0.05). Conclusion: Our study results indicated that cardiac enzyme release was high after On-Pump CABG surgery. However, LVEF decreased in both techniques. There were some advantages of OPCAB operations such as decrease of inflammatory responses and angina pectoris incidence due to extracorporeal circulation; however, these techniques did not affect postoperative mortality and morbidity. Therefore, in selected cases to provide longer operation time, Off-Pump CABG could be used but it has no superiority over On-Pump CABG surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Comparison of Clinical and Biochemical Outcomes in Off-Pump and Conventional Coronary Artery Bypass Grafting Surgery

Temizturk¹,

Azboy²,

Karapinar³

et al. 2015

OALib

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“…Elevated values of these markers after cardiac surgery are indicative of peri-operative myocardial damage during or after the operation and are associated with increased mortality and morbidity in the short and medium term after cardiac surgery. [23][24][25][26][27][28][29] Lower post-operative CK-MB and cTnI values reported in the Cold Blood group were indicative of a better myocardial protection obtained with cold blood cardioplegia.…”

Section: Discussionmentioning

confidence: 99%

Myocardial damage following cardiac surgery: comparison between single-dose Celsior cardioplegic solution and cold blood multi-dose cardioplegia

et al. 2013

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Myocardial protection during cardiac surgery can be accomplished by different cardioplegic solutions. The aim of this study was to assess myocardial damage after heart valve surgery performed with myocardial protection of a single dose of Celsior cardioplegia or with repeated cold blood cardioplegia. After the stratification of 139 valvular patients by means of matching according to cross-clamp and cardiopulmonary bypass time, 32 patients were retained for comparison (16 patients received Celsior and 16 patients received cold blood cardioplegia). Creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) release were evaluated until six days after the operation. Pre-operative characteristics were similar in both groups. In the Celsior group, CK-MB and cTnI values were significantly higher from the first up to the sixth post-operative day. Peak cTnI values were 19.4 ± 13.4 and 9.7 ± 7 ng/mL (p=0.01) in the Celsior and the Cold Blood group, respectively. Peak CK-MB values were 79.6 ± 58.8 and 45.9 ± 20.6 U/L (p=0.07) in the Celsior and the Cold Blood group, respectively. Cold blood cardioplegia reduces perioperative myocardial damage compared to the Celsior solution in elective cardiac valve operations.

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“…For example, in a study of 938 consecutive patients undergoing a range of cardiac surgical procedures, Van Geene et al [8] demonstrated that cTnI levels were significant predictors of inhospital mortality and can identify a subgroup of patients with an increased risk for hospital mortality. In addition, Croal et al [9] found that regardless of other potentially confounding variables, including operation complexity, cTnI levels 24 h after surgery are powerful predictors of short-term and long-term mortality.…”

Section: Discussionmentioning

confidence: 99%

Postoperative levels of cardiac troponin versus CK-MB and high-sensitivity C-reactive protein for the prediction of 1-year cardiovascular outcome in patients undergoing vascular surgery

Kouvelos¹,

Milionis²,

Αrnaoutoglou³

et al. 2011

Coronary Artery Disease

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Cardiac troponin I levels after cardiac surgery as predictor for in-hospital mortality☆

Abstract: Postoperative cTnI level, measured within the first hour after cardiac surgery, can identify a subgroup of patients with increased risk for hospital mortality. These patients may benefit from better monitoring, eventually with specific diagnostic and therapeutic interventions.

Cited by 28 publications

References 16 publications

The Comparison of Clinical and Biochemical Outcomes in Off-Pump and Conventional Coronary Artery Bypass Grafting Surgery

The Comparison of Clinical and Biochemical Outcomes in Off-Pump and Conventional Coronary Artery Bypass Grafting Surgery

Myocardial damage following cardiac surgery: comparison between single-dose Celsior cardioplegic solution and cold blood multi-dose cardioplegia

Postoperative levels of cardiac troponin versus CK-MB and high-sensitivity C-reactive protein for the prediction of 1-year cardiovascular outcome in patients undergoing vascular surgery

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