Usefulness of postoperative high-sensitive troponin T measurement and implications for defining type 5 infarction.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY-NC-ND 4.0
ID Serval
serval:BIB_4D8844864947
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Usefulness of postoperative high-sensitive troponin T measurement and implications for defining type 5 infarction.
Périodique
Journal of cardiac surgery
Auteur⸱e⸱s
Niclauss L., Pfister R., Delay D., Tozzi P., Kirsch M., Prêtre R.
ISSN
1540-8191 (Electronic)
ISSN-L
0886-0440
Statut éditorial
Publié
Date de publication
01/2022
Peer-reviewed
Oui
Volume
37
Numéro
1
Pages
151-161
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Guidelines indicate for type 5 myocardial infarction (MI) that postoperative troponin need not be exclusively ischemic but may also be caused by epicardial injury. Complexity arises from the introduction of high-sensitive troponin. This study attempts to contribute to the understanding of postoperative high-sensitive cardiac troponin T (hs-cTnT) increase.
The median enzyme increase of different cardiac operations was compared. Linear regression analyses were used to determine correlations between enzyme rise and independent parameters. Receiver-operating characteristics (ROC) served to evaluate the discriminatory power of enzyme rise in detecting ischemia and to determine possible thresholds.
Among 400 patients, 2.8% had intervention-related ischemia analogous to type 5 MI definition. The median postoperative hs-cTnT/creatine kinase myocardial band (CK-MB) increase varied according to types of surgery, with highest increase after mitral valve and lowest after off-pump coronary surgery. After ruling out patients with preoperatively elevated hs-cTnT, regression analysis confirmed Maze procedure (p < .001), intra-pericardial defibrillation (p = .002), emergency intervention (p = .01), blood transfusions (p = .02), and cardiopulmonary bypass time (p = .03) as significant factors associated with hs-cTnT increase. In addition, CK-MB increase was associated with mortality (p = .002). ROC confirmed good discriminatory power for hs-cTnT and CK-MB with ischemia-indicating thresholds of 1705.5 ng/L (hs-cTnT) and 113 U/L (CK-MB) considering different types of operations.
The Influence of the type of surgery and intervention-related parameters on hs-cTnT increase was confirmed. Potential thresholds indicating perioperative ischemia appear to be significantly elevated for high sensitive markers.
Mots-clé
Biomarkers, Creatine Kinase, Humans, Infarction, Postoperative Period, Troponin, Troponin T, cardiovascular pathology, cardiovascular research, coronary artery disease, valve repair/replacement
Pubmed
Web of science
Open Access
Oui
Création de la notice
15/11/2021 13:42
Dernière modification de la notice
23/11/2022 7:10
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