Sialic Acid or Troponin T to Detect Perioperative Myocardial Damage in Patients Undergoing Elective Coronary Artery Bypass Grafting.

Berkan, Öcal; Şağban, Mansur

doi:10.1253/circj.66.1019

Cited by 10 publications

(7 citation statements)

References 20 publications

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“…Aortic clamping and extra-corporeal circulation probably constitute the most important causes of metabolic changes in patients undergoing intervention (Savaris et al 2001;Berkan and Sagban 2002). This is confirmed in our study; together with TnT, it is the myoglobin variable that best detects the changes, in relation to the type of surgery.…”

Section: Discussionsupporting

confidence: 83%

Plasma Troponins as Markers of Myocardial Damage during Cardiac Surgery with Extracorporeal Circulation

Stefano¹,

Casquero²,

Bustamante

et al. 2007

Tohoku J. Exp. Med.

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All types of cardiac surgery involve considerable injury to the myocardium. However, it is difficult to differentiate, in the immediate postoperative state, between ischemic alterations associated with the cardiac surgery itself and the pathological alterations of a peri-operative myocardial infarction. The diagnosis of damaged myocardium, classically performed with the enzymatic markers creatine kinase (CK) and its muscle fraction (CK-MB), has become more precise with the option of measuring cardiac troponins T and I. We measured these markers in 58 patients undergoing elective cardiac surgery with extra-corporeal circulation (ECC). The patients included 37 cases undergoing valve surgery, 14 for coronary revascularization, 6 for mixed procedures, and 1 for closure of an inter-atrial communication. The markers were measured in plasma at baseline (at anesthesia initiation), 5 min post-ECC commencement, following aorta de-clamping, during the surgical closure, and 6, 18 and 42 hrs after surgery. All the markers were increased significantly relative to the baseline values. Troponin I, CK and CK-MB values peaked between 6 and 18 hrs after surgery, troponin T between 18 and 42 hrs, and myoglobin at the surgical closure. The values of all markers were higher in patients undergoing coronary surgery compared to those in patients undergoing valve surgery. In the evaluation of myocardial damage after surgery, the measurement of classical markers such as CK and myoglobin remain valid, but other markers such as troponins provide significant additional diagnostic benefit and, thus, need to be included in the routine biochemical measurements for monitoring myocardial damage associated with the surgical procedure.Peri-operative myocardial damage; injury markers; troponin; creatine kinase; myoglobin

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Section: Discussionsupporting

confidence: 83%

Plasma Troponins as Markers of Myocardial Damage during Cardiac Surgery with Extracorporeal Circulation

Stefano¹,

Casquero²,

Bustamante

et al. 2007

Tohoku J. Exp. Med.

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“… 15 Although changes in blood concentrations of cardiac markers, such as CK-MB, myoglobin (Mb) and cardiac troponins are used in the diagnosis of PMI, there are no widely accepted standardised diagnostic criteria. 16 …”

Section: Discussionmentioning

confidence: 99%

High-sensitivity cardiac troponin T is more helpful in detecting peri-operative myocardial injury and apoptosis during coronary artery bypass graft surgery

Koçak

Aksoy

et al. 2015

CVJA

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SummaryAimTo determine whether there is a correlation between cardiac markers and peri-operative myocardial injury (PMI) and apoptosis in coronary artery bypass graft (CABG) surgery and to compare the efficacy of cardiac markers to detect PMI.MethodsThe study population consisted of 37 patients (24 male, 13 female, mean age 63.4 ± 8.9 years) undergoing elective CABG. Arterial and coronary sinus blood samples were collected just before aortic cross-clamping (pre-ACC) and after aortic declamping (post-ACC). Creatine kinase-MB isoenzyme (CK-MB) activity, and high-sensitivity cardiac troponin T (hs-cTnT), creatine kinase-MB isoenzyme mass (CK-MB mass) and cardiac troponin I (cTnI) concentrations were measured in blood samples. Myocardial injury and apoptosis were examined in atrial biopsies.ResultsCABG caused PMI and apoptosis in all cases. Concentrations and net releases of cardiac markers significantly increased after aortic declamping (p < 0.001 for CK-MB and CK-MB mass, p < 0.01 for cTnI, p < 0.05 for hs-cTnT). A positive correlation was found between apoptotic index (r = 0.611, p < 0.001 for cTnI; r = 0.806, p < 0.001 for hs-cTnT), myocardial injury score (r = 0.544, p < 0.001 for cTnI; r = 0.719, p < 0.001 for hs-cTnT) and cTnI and hs-cTnT values in the post-ACC period. A positive correlation was found between apoptotic index (r = 0.507, p < 0.001), myocardial injury score (r = 0.416, p = 0.010) and net release of hs-cTnT. Furthermore, a positive correlation was found between aortic cross-clamp (ACC) time (r = 0.448, p = 0.007), cardiopulmonary bypass (CPB) time (r = 0.342, p = 0.047) and net release of hs-cTnT.ConclusionAlthough both cTnI and hs-cTnT may be specific and efficacious markers of myocardial apoptosis and injury occurring during CABG with CPB, hs-cTnT may be a more useful marker than cTnI to detect peri-operative myocardial apoptosis and injury.

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“…From these reports it seems that irrespective of the mechanism , serum sialic acid seems to be a causal risk factor and could prove useful in screening of population at cardiovascular risk. Recently, serum sialic acid has been shown to be a unique and novel marker that could be particularly useful in assessing myocardial cell damage in patients undergoing cardiac surgery (43).…”

Section: Serum Sialic Acidmentioning

confidence: 99%

Sialic acid in cardiovascular diseases

Nigam

Narain

Kumar

2006

Indian J Clin Biochem

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Sialic acid, the acylated derivatives of 9-carbon sugar neuraminic acid, present as terminal component of oligosaccharide chains of many glycoproteins and glycolipids, has been recognized to be involved in the regulation of a great variety of biological phenomena. Studies have shown that serum sialic acid predicts both coronary heart disease and stroke mortality and reflects the existence or activity of an atherosclerotic process. Most of the studies have shown an elevation in serum sialic acid concentration in coronary heart disease and a positive correlation between the raised serum sialic acid and the severity of the coronary lesions is observed. However, a few contradictory reports are also available. Racial differences in serum sialic acid have also been reported and correlated with international differences in the prevalence of atherosclerosis. Reduced sialic acid content of platelets, erythrocytes and lipoproteins may play important role in the pathogenesis of atherosclerosis. Elucidation of the mechanism of alternation in sialic acid concentration may throw more light on its potential clinical utility. Hence more studies are needed to designate sialic acid as a cardiovascular risk factor / marker.

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Sialic Acid or Troponin T to Detect Perioperative Myocardial Damage in Patients Undergoing Elective Coronary Artery Bypass Grafting.

Cited by 10 publications

References 20 publications

Plasma Troponins as Markers of Myocardial Damage during Cardiac Surgery with Extracorporeal Circulation

Plasma Troponins as Markers of Myocardial Damage during Cardiac Surgery with Extracorporeal Circulation

High-sensitivity cardiac troponin T is more helpful in detecting peri-operative myocardial injury and apoptosis during coronary artery bypass graft surgery

Sialic acid in cardiovascular diseases

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