Document Detail


Cardiac troponin I release after open heart surgery: a marker of myocardial protection?
MedLine Citation:
PMID:  11156125     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Unlike creatine kinase MB isoenzyme, cardiac troponin I (cTnI) is a highly specific marker of myocardial injury. Its release has recently been studied after coronary artery bypass grafting operation. However, its significance after open heart surgery (OHS) remains to be determined. This protein release could be a marker of myocardial protection. We sought to study cTnI release after OHS in patients with normal coronary arteries and to compare it with cTnI release in patients after coronary artery bypass graft (CABG) surgery. METHODS: Eighty-five patients undergoing OHS and 86 patients undergoing CABG were enrolled in the study. CTnI concentrations were measured in serial venous blood samples drawn before surgery and immediately, 12 hours, 24 hours, 48 hours, and 5 days after aortic unclamping. RESULTS: In the OHS group and in the CABG group without acute myocardial infarction (AMI), cTnI peaked at 12 hours postoperatively (6.35 +/- 6.5 and 5.38 +/- 8.55 ng/mL, respectively) and normalized on day 5 postoperatively (0.57 +/- 2 and 0.72 +/- 1.62 ng/mL, respectively). CTnI concentration did not differ significantly between the OHS group and the CABG group in the absence of AMI for any samples considered. In the CABG group, 2 patients had AMI. In the OHS group, cTnI levels at 12 hours postoperatively were found to correlate closely with CPB and aortic cross-clamping (ACC) times, contrary to the CABG group, which correlated only with occurrence of AMI. CTnI release was independent of age and ejection fraction in either group. CONCLUSIONS: cTnI release in patients after OHS with normal coronary arteries has the same profile as cTnI release in patients after CABG in the absence of AMI. However, its peak at 12 hours postoperatively is only correlated to ACC and CPB times, which is contrary to cTnI release after CABG surgery. This observation suggests that cTnI could be a marker of myocardial ischemia after OHS.
Authors:
E Vermes; M Mesguich; R Houel; C Soustelle; P Le Besnerais; M L Hillion; D Loisance
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  70     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2001-01-11     Completed Date:  2001-02-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2087-90     Citation Subset:  AIM; IM    
Affiliation:
Service de Chirurgie Thoracique et Cardiovasculaire, CNRS UPRES A 7054, Association Claude Bernard, H pital Henri Mondor, Créteil, France. loisance@univ-paris12.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Coronary Artery Bypass*
Female
Heart Valve Prosthesis Implantation*
Humans
Male
Middle Aged
Myocardial Infarction / blood,  diagnosis
Myocardial Reperfusion Injury / blood,  diagnosis*
Predictive Value of Tests
Reference Values
Troponin I / blood*
Chemical
Reg. No./Substance:
0/Troponin I

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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