Key result
Red blood cell transfusion during elective cardiac surgery was associated with increased odds of elevated troponin I levels at 24 hours post-surgery (OR 2.33), though this became a non-significant trend after adjusting for surgical factors.
Why the study?
Increased cardiac troponin I has been suggested as a sensitive indicator of intraoperative myocardial injury, but the association of transfusion on post-surgery troponin I levels and outcomes in elective cardiac surgery required investigation.
Does RBC transfusion increase Troponin I levels and worsen outcomes in patients undergoing elective cardiac surgeries?
Cohort (n=542)
No
Does RBC transfusion increase Troponin I levels and worsen outcomes in patients undergoing elective cardiac surgeries?
RBC transfusion during elective cardiac surgery is associated with increased postoperative Troponin I levels and worse clinical outcomes, suggesting potential myocardial injury.
Answers are grounded in this paper and cite their sources.
Transfusion linked to higher troponin but lost significance after adjustment; leaves open whether it causes myocardial injury in elective surgery.
OBJECTIVES: Increased cardiac troponin I (TI) has been suggested to be a sensitive indicator of intraoperative myocardial injury. We investigated the association of transfusion on TI levels post-surgery and outcomes in patients undergoing elective cardiac surgeries. METHODS: We conducted a retrospective review of 542 patients. Patients were divided into two groups based on TI levels at 24 hours (TI24) (> 6.5 µg/L vs. ≤ 6.5 µg/L). The impact of transfusion on TI levels was estimated using logistic regression and adjusted for using a multivariable model that included aortic cross-clamp time and preoperative ejection fraction. The effect of TI on the clinical outcomes was examined. RESULTS: 0.020, 95% CI: 0.69-8.30). CONCLUSIONS: RBC transfusion is associated with increased TI24 post-cardiac surgery and worse outcomes, albeit a confounding effect cannot be excluded. Larger studies are required to confirm these findings.
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Al‐Riyami et al. (2019) conducted a cohort in Elective cardiac surgery (n=542). Red blood cell (RBC) transfusion vs. No RBC transfusion was evaluated on High troponin I levels (> 6.5 µg/L) at 24 hours post-surgery (OR 2.33, 95% CI 1.30-4.30, p=0.007). Red blood cell transfusion during elective cardiac surgery was associated with increased odds of elevated troponin I levels at 24 hours post-surgery (OR 2.33), though this became a non-significant trend after adjusting for surgical factors.
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