Key result
Postoperative hsTnT cutoff of 3466 ng/L identifies perioperative MI with ~90% accuracy after cardiac surgery.
Why the study?
Does highly sensitive troponin T accurately diagnose perioperative myocardial infarction in patients undergoing cardiac surgery?
Observational (n=413)
No
Does highly sensitive troponin T accurately diagnose perioperative myocardial infarction in patients undergoing cardiac surgery?
Effect estimate: C-statistic 0.90 (95% CI 0.75-1.0)
A highly sensitive troponin T cutoff of 3466 ng/L can reliably diagnose perioperative myocardial infarction after cardiac surgery.
May support hsTnT-based PMI diagnosis after cardiac surgery; leaves open need for prospective validation before practice change.
Perioperative myocardial infarction (PMI) confers a considerable risk in cardiac surgery settings; finding the ideal biomarker seems to be an ideal goal. Our aim was to assess the diagnostic accuracy of highly sensitive troponin T (hsTnT) in cardiac surgery settings and to define a diagnostic level for PMI diagnosis. This was a single-center prospective observational study analyzing data from all patients who underwent cardiac surgeries. The primary outcome was the diagnosis of PMI through a specific level. The secondary outcome measures were the lengths of mechanical ventilation (LOV), stay in the intensive care unit (LOSICU), and hospitalization. Based on the third universal definition of PMI, patients were divided into two groups: no PMI (Group I) and PMI (Group II). Data from 413 patients were analyzed. Nine patients fulfilled the diagnostic criteria of PMI, while 41 patients were identified with a 5-fold increase in their CK-MB (≥ 120 U/L). Using ROC analysis, a hsTnT level of 3,466 ng/L or above showed 90% sensitivity and 90% specificity for the diagnosis of PMI. Secondary outcome measures in patients with PMI were significantly prolonged. In conclusion, the hsTnT levels detected here paralleled those of CK-MB and a cut-off level of 3466 ng/L could be diagnostic of PMI.
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Omar et al. (2015) conducted an observational in Cardiac Surgery (n=413). Highly sensitive troponin T (hsTnT) was evaluated on Diagnosis of perioperative myocardial infarction (PMI) (C-statistic 0.90, 95% CI 0.75-1.0). A highly sensitive troponin T cutoff level of 3466 ng/L or above demonstrated 90% sensitivity and 90% specificity for diagnosing perioperative myocardial infarction after cardiac surgery.
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