Min Seop Jo1, Jehoon Lee2, Soo-Young Kim2, Hi Jeong Kwon2, Hae Kyung Lee2, Dong Jin Park2, Yeongsic Kim3. 1. Department of Thoracic and Cardiovascular surgery, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Republic of Korea. 2. Department of Laboratory Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Republic of Korea. 3. Department of Laboratory Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Republic of Korea. Electronic address: yeongsik@catholic.ac.kr.
Abstract
BACKGROUND: Heart-type fatty acid-binding protein (H-FABP) is a cytoplasmic protein and is released form necrotic cardiac myocytes, as well as ischemic cardiac myocytes. In this study, we compared creatine kinase MB (CK-MB), H-FABP, and cardiac troponin T (cTnT) after coronary artery bypass grafting (CABG), heart valve surgery, or septal defect surgery to evaluate the difference in detecting myocardial injury between three markers. METHODS: A total of 69 patients (CABG, 32; valve surgery, 27; and septal defect surgery, 10) were prospectively enrolled. Blood samples were taken at specific intervals. RESULTS: Mean amount (AUC0-72h) of CK-MB and cTnT released for 72 h in the patients with valve surgery were 2446 h·ng/ml and 93.2 h·ng/ml, which were significantly larger than those in the patients with CABG or septal defect surgery (p < .05). Mean amount (AUC0-72h) of H-FABP released for 72 h in the patients with CABG was 1939 h·ng/ml, which was significantly larger than that in the patients with septal defect surgery (700.1 h·ng/ml) (p < .05). CONCLUSION: H-FABP would be a more useful marker for detecting myocardial ischemic injury than CK-MB and cTnT. CK-MB and cTnT would be more sensitive to myocardial injury with surgical trauma than with ischemic injury in the patients with cardiac surgery.
BACKGROUND:Heart-type fatty acid-binding protein (H-FABP) is a cytoplasmic protein and is released form necrotic cardiac myocytes, as well as ischemic cardiac myocytes. In this study, we compared creatine kinase MB (CK-MB), H-FABP, and cardiac troponin T (cTnT) after coronary artery bypass grafting (CABG), heart valve surgery, or septal defect surgery to evaluate the difference in detecting myocardial injury between three markers. METHODS: A total of 69 patients (CABG, 32; valve surgery, 27; and septal defect surgery, 10) were prospectively enrolled. Blood samples were taken at specific intervals. RESULTS: Mean amount (AUC0-72h) of CK-MB and cTnT released for 72 h in the patients with valve surgery were 2446 h·ng/ml and 93.2 h·ng/ml, which were significantly larger than those in the patients with CABG or septal defect surgery (p < .05). Mean amount (AUC0-72h) of H-FABP released for 72 h in the patients with CABG was 1939 h·ng/ml, which was significantly larger than that in the patients with septal defect surgery (700.1 h·ng/ml) (p < .05). CONCLUSION:H-FABP would be a more useful marker for detecting myocardial ischemic injury than CK-MB and cTnT. CK-MB and cTnT would be more sensitive to myocardial injury with surgical trauma than with ischemic injury in the patients with cardiac surgery.
Authors: Viola Weidenmann; N Bryce Robinson; Lisa Q Rong; Irbaz Hameed; Ajita Naik; Mahmoud Morsi; Philippe Grieshaber; Andreas Böning; Leonard N Girardi; Mario Gaudino Journal: Int J Surg Date: 2020-05-19 Impact factor: 6.071