Why the study?
Data were lacking on the relationship between coronary atherosclerotic burden complexity and early post-CABG procedural myocardial injury.
Does the SYNTAX score predict early myocardial injury after on-pump CABG?
Does the SYNTAX score predict early myocardial injury after on-pump CABG?
The SYNTAX score is a strong independent predictor of early postoperative myocardial injury, as measured by cTnI and hFABP, in patients undergoing on-pump CABG.
Answers are grounded in this paper and cite their sources.
Isolated post-CABG biomarker rises signal prognostic injury; leaves open whether atherosclerotic complexity modulates risk.
Introduction: Marked isolated elevation of cardiac biomarkers (CK-MB, cardiac troponin I, heart-type fatty acid binding protein, hFABP) within 48 hours after coronary artery bypass surgery (CABG), even in the absence of electrocardiographic/ angiographic evidence of myocardial infarction (MI), indicates prognostically significant cardiac procedural myocardial injury. There are no data exploring the relationship between the complexity of coronary atherosclerotic burden and early post-CABG myocardial injury. Aim: To analyse correlations and predictive strength of the SYNTAX score (SS) for early myocardial injury after on-pump CABG. Material and methods: One hundred and twenty consecutive patients undergoing CABG were included in the analysis. We obtained data on demographics, medical history, cardiovascular risk factors and echocardiography. Cardiac biomarkers were assessed at 6 hours after CABG. Multivariate linear regression analysis was performed to evaluate independent variables correlated with cardiac biomarkers. Results: The most significant predictor for myocardial injury was SS, strongly correlated with the rise of all cardiac biomarkers (p < 0.001). Hypertension and creatinine clearance were associated with cTnI and hFABP. Diabetes was corelated with hFABP. In a multivariate analysis including all significant predictors, SS remained an independent predictor for myocardial injury, strongly associated with hFABP (p < 0.001, OR = 5.79, 95% CI: 3.59-7.98), cTnI (p < 0.001, OR = 6.49, 95% CI: 4.78-8.20), but not with CK-MB (95% CI: 0.61-1.07). Conclusions: Defining myocardial injury as elevation of cardiac biomarkers between normal values and the cut-off for MI has a tremendous clinical significance as patients maintain high negative prognostic rates. SS could be used to predict postoperative rise of cardiac biomarkers, the correlation between SS and myocardial injury being very solid.
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Namat et al. (2020) studied this question.
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