Document Detail

Diagnostic discrimination between graft-related and non-graft-related perioperative myocardial infarction with cardiac troponin I after coronary artery bypass surgery.
MedLine Citation:
PMID:  16087649     Owner:  NLM     Status:  MEDLINE    
AIMS: The rise of markers for myocardial injury indicates early graft-related or non-graft-related perioperative myocardial infarction (PMI) after coronary artery bypass grafting (CABG). A diagnostic discrimination between these two situations may enable adequate therapeutic measures, limiting myocardial damage, and improving outcome. METHODS AND RESULTS: In a prospective study, 94 among 3308 consecutive CABG patients underwent acute reangiography because of evidence of PMI. Of these 94 patients, 56 had graft-related PMI (group 1), 38 patients had non-graft-related PMI (group 2), and 95 patients without evidence of PMI and angiographically patent grafts served as control (group 3). Cardiac troponin I (cTnI), creatine kinase (CK), and its MB fraction were determined. CTnI, but not CK/CK-MB levels were significantly higher in group 1 than in groups 2 and 3 at 12 and 24 h after aortic unclamping (P<0.0001). Receiver operating characteristic and multivariable logistic regression analyses indicated cTnI as the best discriminator between PMI 'in general' and 'inherent' release of cTnI after CABG with a cut-off value of 10.5 ng/mL and between graft-related and non-graft-related PMI with a cut-off value of 35.5 ng/mL. CONCLUSION: Perioperative cTnI elevation after CABG separates among patients with graft-related, non-graft-related, and without PMI, however, not earlier than 12 h after surgery.
Matthias Thielmann; Parwis Massoudy; Axel Schmermund; Markus Neuhäuser; Günter Marggraf; Markus Kamler; Ulf Herold; Ivan Aleksic; Klaus Mann; Michael Haude; Gerd Heusch; Raimund Erbel; Heinz Jakob
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Publication Detail:
Type:  Journal Article     Date:  2005-08-08
Journal Detail:
Title:  European heart journal     Volume:  26     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-02     Completed Date:  2006-05-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  2440-7     Citation Subset:  IM    
Department of Thoracic and Cardiovascular Surgery, West-German Heart Center Essen, University Hospital of Essen, Hufelandstrasse 55, 45122 Essen, Germany.
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MeSH Terms
Biological Markers / blood
Case-Control Studies
Coronary Angiography
Coronary Artery Bypass / adverse effects*
Creatine Kinase / blood
Creatine Kinase, MB Form / blood
Graft Rejection / blood,  etiology
Middle Aged
Myocardial Infarction / diagnosis*,  etiology
Postoperative Care / methods
ROC Curve
Sensitivity and Specificity
Troponin I / blood*
Reg. No./Substance:
0/Biological Markers; 0/Troponin I; EC Kinase; EC Kinase, MB Form

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