Cardiac Troponin T Levels in On- and Off-Pump Coronary Artery Bypass Surgery

Abstract

In summary, higher postoperative cTnT levels are associated with CCAB than with OPCAB, regardless of priority, number of diseased vessels, patient characteristics, or surgeon. OPCAB results in less myocardial injury in patients, whether they present with 2- or 3-vessel disease and whether they undergo urgent or elective cardiac surgery.

Clinical Relevance of Troponin T Profile Following Cardiac Surgery

“…These include factors related to the surgical procedure as well as factors related to the patient himself. For instance, the duration of cross-clamp time, especially when prolonged over 60 min, is well-known to increase the post-operative values of cTnT (3–7, 12, 23). In addition, the results of the current study seem to indicate that this elevation occurs rather in the early post-operative hours.…”

“…Biomarkers of myocardial injury invariably increase following cardiac surgical interventions. Reasons essentially include the direct surgical trauma to the cardiac tissue, the quality of the myocardial protection, the type of surgery (1, 2), the duration of ischemic cross clamp time (3–7), as well as conditions related to the patient himself, such as the renal function (8–11). Several studies have attempted to define biomarkers' cut-off values to predict outcome after cardiac surgery (1, 12–15).…”

Peripheral tissue metabolism during off-pump versus on-pump coronary artery bypass graft surgery: the microdialysis study☆

“…Several studies confirm the reduction of some postoperative complications associated with the cardiopulmonary bypass. The decrease in the systemic inflammatory response and lower activation of the inflammatory mediators following beating heart surgery [1], decrease in oxidative stress [2] or less myocardial injury with lower levels of myocardial markers [3].…”

Relationship of Off-Pump Coronary Artery Bypass Surgery with the Cardiac Enzyme Troponin T, LVEF, TAPSE and Post-Operative Recovery

“…(1,2) Being a tertiary care hospital, our centre has the wide drainage area from various parts of eastern India and is experiencing very high number of OPCAB done per year. It is a known fact that OPCAB increases cardiac enzymes postoperatively, (3,4) but predicting prognosis based only on this is problematic. (5) Moreover, LVEF is affected in many cases postoperatively and also can be considered as a postoperative prognostic guide, (6) but regarding surgical treatment in triple vessel disease where 70% of hearts are right coronary artery dominated, (7) considering one right ventricular parameter may give a better prognostic value.…”

“…Some literatures suggest cardiac troponin T (Trop-T) measurement may be superior for the outcome prediction than MB isoenzyme of creatine kinase (CPK-MB) and even cardiac troponin I (Trop-I). (3) Trop-T elevation has repeatedly and unequivocally been shown to be prognostic for delayed recovery and longer intensive cardiac care unit (ICU) stay. But assessing prognosis after CABG only with cardiac enzymes like Troponins is not always easy.…”