| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2000;69:435-440
© 2000 The Society of Thoracic Surgeons
a Department of Surgery, Montreal Heart Institute, Montreal, Quebec, Canada
b Department of Laboratory Medicine, Montreal Heart Institute, Montreal, Quebec, Canada
Address reprint requests to Dr Carrier, Montreal Heart Institute, 5000 Belanger St E, Montreal, PQ H1T 1C8, Canada
e-mail: carrier{at}icm.umontreal.ca
Background. The objective of this study was to evaluate serum cardiac troponin T and I levels in patients in whom electrocardiogram, myocardial scan, and serum CK-MB levels of the MB isoenzyme of creatine kinase indicated perioperative myocardial infarction (MI) after coronary artery bypass grafting (CABG).
Methods. We studied 590 patients who underwent CABG at the Montreal Heart Institute between 1992 and 1996. Postoperative cardiac troponin T levels (493 patients), troponin I levels (97 patients), and activity of the MB isoenzyme of creatine kinase, electrocardiograms, clinical data, and clinical events were recorded prospectively. The diagnosis of perioperative PMI was defined by a new Q wave on the electrocardiogram, by serum levels of the MB isoenzyme of creatine kinase higher than 100 IU/L within 48 hours after operation, or both.
Results. After CABG, 22 patients in whom troponin T levels (22/493, 4.5%) and 6 patients in whom troponin I levels (6/97, 6.2%) were measured had sustained a perioperative MI according to current diagnostic criteria. In these patients, troponin T levels higher than 3.4 µg/L 48 hours after CABG best detected the presence of perioperative MI, with an area under the receiver operating characteristic curve of 0.95, a sensitivity of 90%, a specificity of 94%, a positive predictive value of 41%, a negative predictive value of 99%, and a likelihood ratio of 15. Serum troponin I levels higher than 3.9 µg/L 24 hours after CABG confirmed the perioperative MI with an area under the receiver operating curve of 0.86, a sensitivity of 80%, a specificity of 85%, a positive predictive value of 24%, a negative predictive value of 99%, and a likelihood ratio of 5.
Conclusions. Serum troponin T levels higher than 3.4 µg/L 48 hours after CABG correlated best with the diagnosis of perioperative MI. Serum troponin T levels greater than 3.9 µg/L 24 hours after CABG also correlated with the diagnosis of perioperative MI, although a larger experience is needed to confirm the validity of the chosen cutoff value.
This article has been cited by other articles:
|
|
 |
|
  P. Knapik, P. Nadziakiewicz, E. Urbanska, W. Saucha, M. Herdynska, and M. Zembala Cardiopulmonary Bypass Increases Postoperative Glycemia and Insulin Consumption After Coronary Surgery. Ann. Thorac. Surg., June 1, 2009; 87(6): 1859 - 1865. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Petaja, M. Salmenpera, K. Pulkki, and V. Pettila Biochemical Injury Markers and Mortality After Coronary Artery Bypass Grafting: A Systematic Review. Ann. Thorac. Surg., June 1, 2009; 87(6): 1981 - 1992.e3. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. D. Stearns, V. G. Davila-Roman, B. Barzilai, R. E. Thompson, K. L. Grogan, B. Thomas, and C. W. Hogue Jr Prognostic Value of Troponin I Levels for Predicting Adverse Cardiovascular Outcomes in Postmenopausal Women Undergoing Cardiac Surgery Anesth. Analg., March 1, 2009; 108(3): 719 - 726. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Emmiler, C. U. Kocogullari, Y. Ela, and A. Cekirdekci Influence of intracoronary shunt on myocardial damage: a prospective randomized study Eur. J. Cardiothorac. Surg., November 1, 2008; 34(5): 1000 - 1004. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. D Prabhu, I. E Thazhkuni, S. Rajendran, R. A Thamaran, K. A Vellachamy, and M. P Vettath Mammary Artery Patch Reconstruction of Left Anterior Descending Coronary Artery Asian Cardiovasc Thorac Ann, August 1, 2008; 16(4): 313 - 317. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. K. Chowdhury, V. Malik, R. Yadav, S. Seth, L. Ramakrishnan, M. Kalaivani, S. M. Reddy, G. K. Subramaniam, R. Govindappa, and M. Kakani Myocardial injury in coronary artery bypass grafting: On-pump versus off-pump comparison by measuring high-sensitivity C-reactive protein, cardiac troponin I, heart-type fatty acid-binding protein, creatine kinase-MB, and myoglobin release. J. Thorac. Cardiovasc. Surg., May 1, 2008; 135(5): 1110 - 1119.e10. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Simon, F. Capuano, A. Roscitano, U. Benedetto, C. Comito, and R. Sinatra Cardiac Troponin I vs EuroSCORE: Myocardial Infarction and Hospital Mortality Asian Cardiovasc Thorac Ann, April 1, 2008; 16(2): 97 - 102. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Nesher, A. A. Alghamdi, S. K. Singh, J. Y. Sever, G. T. Christakis, B. S. Goldman, G. N. Cohen, F. Moussa, and S. E. Fremes Troponin after Cardiac Surgery: A Predictor or a Phenomenon? Ann. Thorac. Surg., April 1, 2008; 85(4): 1348 - 1354. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Onorati, L. Cristodoro, S. Caroleo, A. Esposito, B. Amantea, E. Santangelo, and A. Renzulli Troponin I and Lactate From Coronary Sinus Predict Cardiac Complications After Myocardial Revascularization Ann. Thorac. Surg., March 1, 2007; 83(3): 1016 - 1023. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Thielmann, P. Massoudy, M. Neuhauser, K. Tsagakis, G. Marggraf, M. Kamler, K. Mann, R. Erbel, and H. Jakob Prognostic Value of Preoperative Cardiac Troponin I in Patients Undergoing Emergency Coronary Artery Bypass Surgery With Non-ST-Elevation or ST-Elevation Acute Coronary Syndromes Circulation, July 4, 2006; 114(1_suppl): I-448 - I-453. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P.-S. Wong, A. Asmat, Y.-H. Chan, and C.-N. Lee A randomized, double-blind, placebo-controlled trial of a COX-2 inhibitor (Rofecoxib) in patients undergoing coronary artery bypass surgery Interactive CardioVascular and Thoracic Surgery, April 1, 2006; 5(2): 101 - 104. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Gurbuz, B. Emrecan, L. Yilik, I. Ozsoyler, M. Kestelli, C. Ozbek, and N. Karahan Intracoronary shunt reduces postoperative troponin leaks: a prospective randomized study Eur. J. Cardiothorac. Surg., February 1, 2006; 29(2): 186 - 189. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. C Whitaker, J. Stygall, M. J. Harrison, I. J Mackie, M. Kemp, J. Hooper, W. B Pugsley, and S. P Newman Leucocyte-depleting arterial line filtration does not reduce myocardial injury assessed by Troponin T during routine coronary artery bypass grafting using crossclamp fibrillation Perfusion, January 1, 2006; 21(1): 55 - 60. [Abstract] [PDF]
|
|
|
|
 |
|
 L. Babuin and A. S. Jaffe Troponin: the biomarker of choice for the detection of cardiac injury Can. Med. Assoc. J., November 8, 2005; 173(10): 1191 - 1202. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Thielmann, P. Massoudy, A. Schmermund, M. Neuhauser, G. Marggraf, M. Kamler, U. Herold, I. Aleksic, K. Mann, M. Haude, et al. Diagnostic discrimination between graft-related and non-graft-related perioperative myocardial infarction with cardiac troponin I after coronary artery bypass surgery Eur. Heart J., November 2, 2005; 26(22): 2440 - 2447. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Rajappa and A. Sharma Biomarkers of Cardiac Injury: An Update Angiology, November 1, 2005; 56(6): 677 - 691. [Abstract] [PDF]
|
|
|
|
|
|
D. Paparella, G. Cappabianca, G. Visicchio, A. Galeone, A. Marzovillo, N. Gallo, C. Memmola, and L. d. L. T. Schinosa Cardiac Troponin I Release After Coronary Artery Bypass Grafting Operation: Effects on Operative and Midterm Survival Ann. Thorac. Surg., November 1, 2005; 80(5): 1758 - 1764. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J Steuer, F Granath, U de Faire, A Ekbom, and E Stahle Increased risk of heart failure as a consequence of perioperative myocardial injury after coronary artery bypass grafting Heart, June 1, 2005; 91(6): 754 - 758. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Onorati, M. De Feo, P. Mastroroberto, L. Cristodoro, F. Pezzo, A. Renzulli, and M. Cotrufo Determinants and Prognosis of Myocardial Damage After Coronary Artery Bypass Grafting Ann. Thorac. Surg., March 1, 2005; 79(3): 837 - 845. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. F. Salamonsen, H.-G. Schneider, M. Bailey, and A. J. Taylor Cardiac Troponin I Concentrations, but Not Electrocardiographic Results, Predict an Extended Hospital Stay after Coronary Artery Bypass Graft Surgery Clin. Chem., January 1, 2005; 51(1): 40 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Botha, D. V. Nagarajan, P. S. Lewis, and J. Dunning Can cardiac troponins be used to diagnose a perioperative myocardial infarction post cardiac surgery? Interactive CardioVascular and Thoracic Surgery, September 1, 2004; 3(3): 442 - 449. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Steuer, T. Bjerner, O. Duvernoy, L. Jideus, L. Johansson, H. Ahlstrom, E. Stahle, and B. Lindahl Visualisation and quantification of peri-operative myocardial infarction after coronary artery bypass surgery with contrast-enhanced magnetic resonance imaging Eur. Heart J., August 1, 2004; 25(15): 1293 - 1299. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Thielmann, P. Massoudy, G. Marggraf, S. Knipp, A. Schmermund, J. Piotrowski, R. Erbel, and H. Jakob Role of troponin I, myoglobin, and creatine kinase for the detection of early graft failure following coronary artery bypass grafting Eur. J. Cardiothorac. Surg., July 1, 2004; 26(1): 102 - 109. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Gavard, B. R. Chaitman, S. Sakai, K. Stocke, N. Danchin, L. Erhardt, R. Gallo, E. Chi, A. Jessel, and P. Theroux Prognostic significance of elevated creatine kinase MB after coronary bypass surgery and after an acute coronary syndrome: results from the GUARDIAN trial J. Thorac. Cardiovasc. Surg., September 1, 2003; 126(3): 807 - 813. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. A. McAlister, J. Man, L. Bistritz, H. Amad, and P. Tandon Diabetes and Coronary Artery Bypass Surgery: An examination of perioperative glycemic control and outcomes Diabetes Care, May 1, 2003; 26(5): 1518 - 1524. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Carrier, D. Robitaille, L. P. Perrault, M. Pellerin, P. Page, R. Cartier, and D. Bouchard Heparin versus danaparoid in off-pump coronary bypass grafting: Results of a prospective randomized clinical trial J. Thorac. Cardiovasc. Surg., February 1, 2003; 125(2): 325 - 329. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Nesher, E. Zisman, T. Wolf, R. Sharony, G. Bolotin, M. David, G. Uretzky, and R. Pizov Strict Thermoregulation Attenuates Myocardial Injury During Coronary Artery Bypass Graft Surgery as Reflected by Reduced Levels of Cardiac-Specific Troponin I Anesth. Analg., February 1, 2003; 96(2): 328 - 335. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. J. Brener, B. W. Lytle, J. P. Schneider, S. G. Ellis, and E. J. Topol Association between CK-MB elevation after percutaneous or surgical revascularization and three-year mortality J. Am. Coll. Cardiol., December 4, 2002; 40(11): 1961 - 1967. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. H. Hovels-Gurich, J. F. Vazquez-Jimenez, A. Silvestri, K. Schumacher, R. Minkenberg, J. Duchateau, B. J. Messmer, G. von Bernuth, and M.-C. Seghaye Production of proinflammatory cytokines and myocardial dysfunction after arterial switch operation in neonates with transposition of the great arteries J. Thorac. Cardiovasc. Surg., October 1, 2002; 124(4): 811 - 820. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. J. Fransen, J. H. C. Diris, J. G. Maessen, W. Th. Hermens, and M. P. van Dieijen-Visser Evaluation of "New" Cardiac Markers for Ruling Out Myocardial Infarction After Coronary Artery Bypass Grafting Chest, October 1, 2002; 122(4): 1316 - 1321. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Nass and L. A. Fleisher Diagnosing Perioperative Myocardial Infarction in Cardioth oracic and Vascular Surgery Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2002; 6(3): 219 - 227. [Abstract] [PDF]
|
|
|
|
|
|
J. M. Albes, M. Gross, U. Franke, J. Wippermann, T. U. Cohnert, R. Vollandt, and T. Wahlers Revascularization during acute myocardial infarction: risks and benefits revisited Ann. Thorac. Surg., July 1, 2002; 74(1): 102 - 108. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Holmvang, B. Jurlander, C. Rasmussen, J. J. Thiis, P. Grande, and P. Clemmensen Use of Biochemical Markers of Infarction for Diagnosing Perioperative Myocardial Infarction and Early Graft Occlusion After Coronary Artery Bypass Surgery Chest, January 1, 2002; 121(1): 103 - 111. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L.K.K. Teoh, R. Grant, J.A. Hulf, W.B. Pugsley, and D.M. Yellon The effect of preconditioning (ischemic and pharmacological) on myocardial necrosis following coronary artery bypass graft surgery Cardiovasc Res, January 1, 2002; 53(1): 175 - 180. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Klatte, B. R. Chaitman, P. Theroux, J. A. Gavard, K. Stocke, S. Boyce, C. Bartels, B. Keller, A. Jessel, and for the GUARDIAN Investigators Increased mortality after coronary artery bypass graft surgery is associated with increased levels of postoperative creatine kinase-myocardial band isoenzyme release: Results from the GUARDIAN trial J. Am. Coll. Cardiol., October 1, 2001; 38(4): 1070 - 1077. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Eigel, G. van Ingen, and S. Wagenpfeil Predictive value of perioperative cardiac Troponin I for adverse outcome in coronary artery bypass surgery Eur. J. Cardiothorac. Surg., September 1, 2001; 20(3): 544 - 549. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. D. Mentzelopoulos, J. N. Kokotsakis, C. N. Romana, and E. A. Karamichali Intracoronary Thrombolysis and Intraaortic Balloon Counterpulsation for the Emergency Treatment of Probable Coronary Embolism After Repair of an Acute Ascending Aortic Dissection Anesth. Analg., July 1, 2001; 93(1): 56 - 59. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Petzold, P. Feindt, U. Sunderdiek, U. Boeken, Y. Fischer, and E. Gams Heart-type fatty acid binding protein (hFABP) in the diagnosis of myocardial damage in coronary artery bypass grafting Eur. J. Cardiothorac. Surg., June 1, 2001; 19(6): 859 - 864. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
