Key result
A 100-unit increase in high-sensitivity troponin T levels at 24 hours after on-pump coronary artery bypass grafting was associated with a 38% increased risk of 1-year major adverse cardiovascular events (HR 1.38).
Why the study?
Previous studies established the predictive value of CK-MB and hs-TnT in CABG mainly for perioperative complications, leaving their longer-term preoperative and postoperative prognostic value in on-pump CABG to be assessed.
Do preoperative and postoperative levels of hs-TnT and CK-MB predict 1-year MACE in patients undergoing on-pump CABG?
Cohort (n=3,188)
No
Do preoperative and postoperative levels of hs-TnT and CK-MB predict 1-year MACE in patients undergoing on-pump CABG?
Preoperative and postoperative serum levels of hs-TnT and CK-MB are significant predictors of 1-year MACE in patients undergoing on-pump CABG.
May refine 1-year MACE risk stratification after CABG; extends observational biomarker data but leaves open prospective validation.
Background: The predictive value of creatine kinase-myocardial band (CK-MB) and high-sensitivity troponin T (hs-TnT) for adverse outcomes in coronary artery bypass grafting (CABG) has been well established in previous studies. However, most of these investigations have focused on perioperative complications. The present study assessed the preoperative and postoperative prognostic value of hs-TnT and CK-MB in individuals undergoing on-pump CABG. Methods: This cohort study included patients who underwent isolated on-pump CABG at a tertiary hospital, Tehran Heart Center, between November 2018 and March 2021. We evaluated the associations of preoperative and postoperative hs-TnT and CK-MB levels with the incidence of major adverse cardiovascular events (MACE) within 1 year after surgery. Results: Of the 3,188 participants, 231 (7.2%) experienced MACE. Factors associated with a higher incidence of MACE included older age, diabetes mellitus, history of peripheral vascular disease, lower left ventricular ejection fraction, and the occurrence of acute kidney injury after surgery. The adjusted hazard ratios (HRs) for the association between hs-TnT levels and 1-year MACE were 1.17 (95% confidence interval [CI], 1.07-1.29; p<0.001) for preoperative levels, 1.22 (95% CI, 1.02-1.47; p=0.044) at 8 hours post-surgery, and 1.38 (95% CI, 1.17-1.62; p<0.001) at 24 hours post-surgery. CK-MB levels at 8 hours (HR, 1.05; 95% CI, 1.01-1.10; p=0.023) and 24 hours (HR, 1.07; 95% CI, 1.04-1.10; p<0.001) after surgery were also associated with adverse events. Conclusion: Preoperative and postoperative serum levels of hs-TnT and CK-MB may be considered significant predictors of MACE within 1 year after on-pump CABG.
No takes yet. Share an insight, caveat, or question.
Ebadi et al. (2025) conducted a cohort in Coronary artery disease requiring on-pump coronary artery bypass grafting (n=3,188). Elevated high-sensitivity troponin T (hs-TnT) and CK-MB levels vs. Lower levels of hs-TnT and CK-MB was evaluated on Major adverse cardiovascular events (MACE) within 1 year after surgery (HR 1.38, 95% CI 1.17-1.62, p=<0.001). A 100-unit increase in high-sensitivity troponin T levels at 24 hours after on-pump coronary artery bypass grafting was associated with a 38% increased risk of 1-year major adverse cardiovascular events (HR 1.38).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: