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Ann Thorac Surg 2008;86:1721. doi:10.1016/j.athoracsur.2008.05.023
© 2008 The Society of Thoracic Surgeons
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Correspondence

Time of Measurement of Troponin is Essential When We Think About Prediction or Phenomena

Omid Assar, MD, Jmashid Bagheri, MD, Mohammad Hossein Mandegar, MD, Farideh Roshanali, MD

Cardiac Surgery Department, Shariati General Hospital, Aleahmad Ave, Tehran, 14666 Iran

(Email: farideh_roshanali{at}yahoo.com).

To the Editor:

We read with great interest the article by Nesher and associates [1] regarding troponin after cardiac surgery. They have measured troponin T levels within 24 hours after surgery. As Luo and colleagues [2] showed, the greatest increase in troponin occurs between 30 minutes to 8 hours post clamping, and then it decreases so that its level is more than 100% lower 24 hours after surgery.

In the Kaplan and colleagues [3] study this decrease was reported at approximately 25%, which chimes with what we see in our center.

Therefore, measuring troponin T within 24 hours postoperatively to determine the cut-off value for the detection of significant myocardial damage does not seem accurate enough, given the substantial difference between its levels during this invaluable period for diagnosis and prediction of major adverse cardiac events. We would suggest that troponin-T be measured at a specified time (eg, 1 hour after surgery).


   References
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 References
 

  1. Nesher N, Alghamdi AA, Singh SK, et al. Troponin after cardiac surgery: a predictor or a phenomenon? Ann Thorac Surg 2008;85:1348-1354.[Abstract/Free Full Text]
  2. Luo WJ, Qian JF, Jiang HH. Pretreatment with aminophylline reduces release of troponin I and neutrophil activation in the myocardium of patients undergoing cardioplegic arrest Eur J Cardiothorac Surg 2007;31:360-365.[Abstract/Free Full Text]
  3. Kaplan S, Ozisik K, Morgan JA, Dogan R. Measurement of troponin T and I to detect cardioprotective effect of aminophylline during coronary artery bypass grafting Interact Cardiovasc Thorac Surg 2003;2:310-315.[Abstract/Free Full Text]




This Article
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