Original articleCardiovascularPrognostic Significance of Elevated Cardiac Troponin I After Heart Surgery
Section snippets
Patient Population and Data Acquisition
The study included 696 consecutive patients who underwent CABG and 490 consecutive patients who underwent valve surgery with or without concomitant CABG at the Minneapolis Veterans Affairs (VA) Medical Center between January 1998 and December 2004. Patients undergoing other cardiac or thoracic procedures, 1 patient who died in the operating room, and 3 others who did not have postoperative cTnI were excluded from this analysis. Patients hospitalized for acute coronary syndrome who were operated
Patient Characteristics
A total of 1,186 patients who underwent CABG and valve surgery were studied. The mean age of the study population was 66 ± 10 years, 83 patients (7%) were octogenarians, and all but 6 were men (Table 1). Of the 1,186 patients, 481 (41%) had prior myocardial infarction, 134 (11%) had prior heart surgery, and 324 (27%) had left ventricular systolic dysfunction (ejection fraction <45%). On presentation, 386 patients (33%) were severely limited (classes III/IV) by heart failure and 687 (58%) by
Comment
This investigation showed that for a large cohort of patients undergoing CABG or valve surgery, cTnI measured 24 hours postoperatively was an independent predictor of operative mortality and perioperative myocardial infarction. Furthermore, including cTnI in addition to a preoperative risk score (eg, EuroSCORE or VA risk score) in the prediction model improved the model in discriminating patients who survived from patients who died compared with when the risk score or cTnI were considered
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2018, Annals of Thoracic SurgeryAssociation of Troponin Trends and Cardiac Morbidity and Mortality After On-Pump Cardiac Surgery
2017, Annals of Thoracic SurgeryHigh-Sensitivity Troponin Release Profile After Cardiac Surgery
2017, Heart Lung and CirculationCelsior Versus Microplegia: Analysis of Myocardial Protection in Elective Aortic Valve Replacement
2017, Annals of Thoracic SurgeryCitation Excerpt :A single TnT measurement 24 hours after the operation is associated with elevated mortality rate and longer hospital stay [19, 20]. Our data showed that TnT release had a good discriminative power to predict postoperative death (Fig 2), as has been previously described [19, 20]. TnT significantly increased with clamp time, and the adjusted time-related increase was lower in the Celsior group (Table 2).
Myocardial damage influences short- and mid-term survival after valve surgery: A prospective multicenter study
2014, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :To date, far few smaller studies have evaluated this aspect. Adabag and colleagues,5 in a retrospective, single-center study, evaluated 696 CABG patients and 490 valve patients and demonstrated that greater cTnI elevation after surgery was associated with increased mortality and a greater incidence of myocardial infarction.5 The analysis of the 490 valve patients was performed combining AVS and MVS, and no information regarding survival after hospital discharge was available.