Key result
The complexity of coronary artery disease, assessed by SYNTAX Scores I and II, showed no significant correlation with the release of high-sensitivity cardiac troponin T or CK-MB after isolated CABG.
Why the study?
In patients with complex CAD undergoing cardiac surgery, impaired myocardial protection from microvascular obstruction may cause myocardial injury, prompting investigation into whether CAD complexity correlates with post-CABG biomarker release.
Does a higher complexity of coronary artery disease (reflected by SYNTAX Scores I and II) increase the postoperative release of cardiac biomarkers (hs-cTnT and CK-MB) in patients undergoing isolated on-pump CABG?
Observational (n=919)
No
Does a higher complexity of coronary artery disease (reflected by SYNTAX Scores I and II) increase the postoperative release of cardiac biomarkers (hs-cTnT and CK-MB) in patients undergoing isolated on-pump CABG?
Coronary artery disease complexity (measured by SYNTAX Scores I and II) is not associated with postoperative hs-cTnT or CK-MB release after on-pump CABG, indicating that patients with more complex CAD do not require higher biomarker cut-offs for diagnosing perioperative myocardial injury.
Answers are grounded in this paper and cite their sources.
No association between SYNTAX scores and post-CABG biomarkers; hypothesis-generating for other determinants of myocardial injury.
Objective: In patients with complex coronary artery disease (CAD) undergoing cardiac surgery, myocardial protection might be impaired due to microvascular obstruction, resulting in myocardial injury and subsequent biomarker release. Therefore, this study investigated the correlation between the complexity of CAD, reflected by the SYNTAX Score, and the release of cardiac biomarkers after CABG. Methods: In a consecutive series of 919 patients undergoing isolated CABG SYNTAX scores I and II were calculated to assess the complexity of CAD. Levels of high sensitivity cardiac troponin T (hs-cTnT) and creatine kinase-myocardial band (CK-MB) were routinely measured once before and serially after surgery. Patients were divided into tertiles according to their SYNTAX Scores I and II. Spearman correlations and regression models were performed to measure the degree of association between the release of hs-cTnT and CK-MB and the SYNTAX Scores. Results: Patients with a higher SYNTAX Score I had more comorbidities reflected in a higher EuroSCORE II. Preoperatively, higher levels of cardiac biomarkers were found in patients with higher SYNTAX Score II. No correlation was observed between hs-cTnT, CK-MB and SYNTAX Score I or II. Regression models did not show any association between cardiac biomarkers and the complexity of CAD. Conclusion: The complexity of CAD is not associated with the release of cardiac biomarkers after CABG. Factors influencing postoperative biomarker release need to be elucidated in future trials to include postoperative biomarker release into risk stratification models predicting outcome after cardiac surgery.
No takes yet. Share an insight, caveat, or question.
Pölzl et al. (2024) conducted an observational in Coronary artery disease (n=919). Complexity of coronary artery disease (SYNTAX Score) vs. Lower complexity (lower SYNTAX Score tertiles) was evaluated on Correlation between SYNTAX Score I and postoperative hs-cTnT release (ρ = 0.041, p=0.212). The complexity of coronary artery disease, assessed by SYNTAX Scores I and II, showed no significant correlation with the release of high-sensitivity cardiac troponin T or CK-MB after isolated CABG.
Synapse has enriched 10 related papers. Consider them for comparative context: