Key result
Postoperative troponin T elevation occurred in 95% of low-risk patients undergoing elective on-pump CABG and was associated with procedural duration but not with clinical outcomes.
Why the study?
Does postoperative troponin T elevation correlate with perioperative variables and predict adverse clinical outcomes in low-risk patients undergoing first-time elective on-pump coronary artery bypass surgery?
Cohort (n=100)
Does postoperative troponin T elevation correlate with perioperative variables and predict adverse clinical outcomes in low-risk patients undergoing first-time elective on-pump coronary artery bypass surgery?
In low-risk patients undergoing elective on-pump CABG, postoperative troponin T elevation is nearly universal and correlates with procedural duration but does not predict short-term adverse clinical outcomes.
Troponin elevations should not alter care in low-risk elective CABG; leaves open long-term prognostic value.
OBJECTIVE: Elevation in markers of myocardial necrosis is a common feature following coronary artery bypass surgery, but its relevance is unclear. The objective of this study was to evaluate the association between postoperative troponin T elevation, perioperative variables and clinical outcomes. METHODS: We evaluated 100 low-risk patients undergoing first-time elective on-pump coronary artery bypass surgery. The mean age was 62 +/- 9.8 years and 83% were male; patients with diabetes mellitus, renal failure and impaired left ventricular function (ejection fraction < 40%) were excluded. Troponin levels were measured at baseline and 12 and 24 h following the onset of cardiopulmonary bypass. Predefined clinical endpoints included death, new Q waves on 12-lead electrocardiogram and inotropic requirement. RESULTS: Postoperative troponin elevation occurred in 95%. Troponin T elevation was related to the duration of cardiopulmonary bypass (P = 0.0001) and aortic cross-clamp time (P = 0.0003). There was also an inverse relationship with perioperative core temperature (P = 0.0001). There was no association between postoperative troponin elevation and clinical outcomes. CONCLUSIONS: Postoperative troponin T elevation occurs in the majority of patients undergoing elective on-pump coronary artery bypass surgery. In this low-risk cohort, troponin T elevation was associated with procedural duration but not with clinical outcome.
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Cosgrave et al. (2006) conducted a cohort in Coronary artery bypass surgery (n=100). Postoperative troponin T elevation was evaluated on Death, new Q waves on 12-lead electrocardiogram and inotropic requirement. Postoperative troponin T elevation occurred in 95% of low-risk patients undergoing elective on-pump CABG and was associated with procedural duration but not with clinical outcomes.
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