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Clinical Relevance of Troponin T Profile Following Cardiac Surgery
- Source :
- Frontiers in Cardiovascular Medicine, Frontiers in Cardiovascular Medicine, Vol 5 (2018), Tevaearai Stahel, Hendrik; Do, Peter D; Klaus, Jeremias; Gahl, Brigitta; Locca, Didier; Göber, Volkhard; Carrel, Thierry P (2018). Clinical Relevance of Troponin T Profile Following Cardiac Surgery. Frontiers in cardiovascular medicine, 5(182), p. 182. Frontiers 10.3389/fcvm.2018.00182
- Publication Year :
- 2018
-
Abstract
- Background: Peak post-operative cardiac troponin T (cTnT) independently predicts mid- and long-term outcome of cardiac surgery patients. A few studies however have reported two peaks of cTnT over the first 48–72 h following myocardial reperfusion. The aim of the current study was to better understand underlying reasons of these different cTnT profiles and their possible relevance in terms of clinical outcome.Methods: All consecutive adult cardiac surgical procedures performed with an extra-corporeal circulation during a >6 years period were retrospectively evaluated. Patients with a myocardial infarction (MI) < 8 days were excluded. cTnT profile of patients with at least one value ≥1 ng/mL value were categorized according to the time occurrence of the peak value. Univariable and multivariable analysis were performed to identify factors influencing early vs. late increase of cTnT values, and to verify the correlation of early vs. late increase with clinical outcome.Results: Data of 5,146 patients were retrieved from our prospectively managed registry. From 953 with at least one cTnT value ≥1 ng/mL, peak occurred ≤ 6 h (n = 22), >6 to ≤ 12 h (n = 366), >12 to ≤ 18 h (n = 176), >18 to ≤ 24 h (171), >24 h (218). Age (OR: 1.023; CI: 1.016–1.030) and isolated CABG (OR: 1.779; CI: 1.114–2.839) were independent predictors of a late increase of cTnT over a limit of 1 ng/ml (p < 0.05), whereas isolated valve procedures (OR: 0.685; CI: 0.471–0.998) and cross-clamp duration (OR: 0.993; CI: 0.990–0.997) independently predicted an early elevation (p < 0.05). Delayed elevation as opposed to early elevation correlated with a higher rate of post-operative complications including MI (19.8 vs. 7.2%), new renal insufficiency (16.3 vs. 6.7%), MACCE (32.0 vs. 15.5%), or death (7.4 vs. 4.4%).Conclusion: Profile of cTnT elevation following cardiac surgery depends on patients' intrinsic factors, type of surgery and duration of cross-clamp time. Delayed increase is of higher clinically relevance than prompt post-operative elevation.
- Subjects :
- medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system
complications
610 Medicine & health
030204 cardiovascular system & hematology
Cardiovascular Medicine
03 medical and health sciences
0302 clinical medicine
Troponin complex
Internal medicine
cardiac biomarkers
medicine
Clinical significance
030212 general & internal medicine
Myocardial infarction
CABG
Original Research
Myocardial reperfusion
biology
Troponin T
business.industry
troponin
Surgical procedures
medicine.disease
Troponin
Cardiac surgery
lcsh:RC666-701
biology.protein
Cardiology
business
Cardiology and Cardiovascular Medicine
cardiac surgery
Subjects
Details
- ISSN :
- 2297055X
- Volume :
- 5
- Database :
- OpenAIRE
- Journal :
- Frontiers in cardiovascular medicine
- Accession number :
- edsair.doi.dedup.....ada2e803089eab5261c194a9998d4437