Key result
Mediastinitis following CABG was associated with significantly higher serum levels of NT-proBNP (65.0 vs 34.8 pg/ml) and troponin T (14.7 vs 11.2 ng/L) at a median follow-up of 2.7 years.
Why the study?
Mediastinitis after CABG increases internal mammary artery graft obstruction risk and impairs long-term survival, but the pathogenesis underlying this increased mortality is poorly understood.
Does post-operative mediastinitis increase the levels of cardiac biomarkers (NT-proBNP and Troponin T) at mid-term follow-up in patients undergoing CABG?
Cohort (n=82)
Yes
Does post-operative mediastinitis increase the levels of cardiac biomarkers (NT-proBNP and Troponin T) at mid-term follow-up in patients undergoing CABG?
Mediastinitis following CABG is associated with persistently elevated cardiac biomarkers (NT-proBNP and TnT) at mid-term follow-up, suggesting ongoing myocardial injury and impaired cardiac function.
May warrant closer surveillance for cardiac dysfunction after mediastinitis; leaves open causal mechanisms and need for prospective trials.
Background Mediastinitis after coronary bypass grafting (CABG) increases the risk of the internal mammary artery (IMA) graft obstruction, and has a detrimental effect on long-term survival. The pathogenesis for this increased mortality is poorly understood. In the present study, we aimed to investigate the relationship between mediastinitis and persistently elevated cardiac-specific biomarkers [troponin T (TnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP)] and C-reactive protein (CRP) at mid-term follow-up following CABG. Material and methods The epidemiologic design was of an exposed (mediastinitis, n = 41) vs. randomly selected non-exposed (non-mediastinitis) controls ( n = 41) cohort. Serum samples for measurements of NT-proBNP, TnT, and CRP were obtained at a median follow up time of 2.7 (range 0.5–5.2) years after CABG surgery. Results NT-proBNP (mean 65.0 pg/ml vs. 34.8 pg/ml, p = 0.007) and TnT levels (mean 14.7 ng/L vs. 11.2 ng/L, p = 0.004) were significantly higher in the mediastinitis group than in the control group. Patients with mediastinitis had also higher body mass index (BMI) and were more likely to have diabetes and previous myocardial infarction. There was no difference in serum CRP level between the groups. After controlling for potential confounders (previous myocardial infarction, age, and BMI), the presence of mediastinitis was associated with higher levels of log NT-proBNP ( p = 0.02) and log TnT ( p = 0.04). Conclusion Mediastinitis increases the concentrations of cardiac-specific biomarkers NT-proBNP and TnT at mid-term follow-up, representing persistent myocardial injury and impaired cardiac function.
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Risnes et al. (2023) conducted a cohort in Post-CABG mediastinitis (n=82). Mediastinitis vs. No mediastinitis was evaluated on NT-proBNP levels (pg/ml) (p=0.007). Mediastinitis following CABG was associated with significantly higher serum levels of NT-proBNP (65.0 vs 34.8 pg/ml) and troponin T (14.7 vs 11.2 ng/L) at a median follow-up of 2.7 years.
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