K Hashemzadeh1, M Dehdilani. 1. Department of Cardiovascular Surgery, Shahid Madani Cardiovascular Research Center, Tabriz University of Medical Sciences, Iran. khhashemzadeh41@yahoo.com
Abstract
AIM: All types of cardiac surgery involve considerable injury to the myocardium. However, little is known about the prognostic value of cardiac troponin (cTnI), which is a cardiac-specific biologic marker. The purpose of this prospective study was to evaluate the prognostic value of cTnI concentrations measured 20 hours after the end of surgery in patients undergoing coronary bypass grafting (CABG). METHODS: Three hundred twenty consecutive patients undergoing CABG surgery during an 18-month period were enrolled. In-hospital death (N.=10), cause of death, major clinical outcomes, and relationship between cTnI concentrations and clinical outcome were recorded. RESULTS: cTnI concentration was an independent predictor of in-hospital mortality (cTnI >14 ng/mL, P<0.05). The perioperative and postoperative variables independently associated with in-hospital death were female gender, combined surgery, ejection fraction <30%, cardiopulmonary bypass duration, and total chest tube drainage volume. CONCLUSIONS: Our study indicates that cTnI concentration 20 hours after the end of surgery is an independent predictor of in-hospital death after CABG. Furthermore, high concentrations of cTnI were associated with a cardiac cause of death and major clinical outcomes.
AIM: All types of cardiac surgery involve considerable injury to the myocardium. However, little is known about the prognostic value of cardiac troponin (cTnI), which is a cardiac-specific biologic marker. The purpose of this prospective study was to evaluate the prognostic value of cTnI concentrations measured 20 hours after the end of surgery in patients undergoing coronary bypass grafting (CABG). METHODS: Three hundred twenty consecutive patients undergoing CABG surgery during an 18-month period were enrolled. In-hospital death (N.=10), cause of death, major clinical outcomes, and relationship between cTnI concentrations and clinical outcome were recorded. RESULTS: cTnI concentration was an independent predictor of in-hospital mortality (cTnI >14 ng/mL, P<0.05). The perioperative and postoperative variables independently associated with in-hospital death were female gender, combined surgery, ejection fraction <30%, cardiopulmonary bypass duration, and total chest tube drainage volume. CONCLUSIONS: Our study indicates that cTnI concentration 20 hours after the end of surgery is an independent predictor of in-hospital death after CABG. Furthermore, high concentrations of cTnI were associated with a cardiac cause of death and major clinical outcomes.