Document Detail


Troponin T is a better predictor than creatine kinase-MB of long-term mortality after coronary artery bypass graft surgery.
MedLine Citation:
PMID:  23137510     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Elevations of creatine kinase-MB (CK-MB) and cardiac troponin T (cTnT) have an uncertain long-term prognostic value after coronary artery bypass graft (CABG) surgery. We aimed to test the hypothesis that CK-MB and cTnT are predictors of long-term survival after CABG and to assess which of these 2 biomarkers is the better predictor.
METHODS: A total of 1,350 consecutive patients undergoing isolated on-pump CABG had CK-MB and cTnT measured at 7, 20, and 44 hours, postoperatively. The end point was all-cause mortality, and during the median follow-up time of 6.1 years, 207 patients (15.3%) died.
RESULTS: Both peak CK-MB and peak cTnT independently predicted long-term mortality (hazard ratio [HR] 1.003, 95% confidence interval [CI] 1.001-1.005, P = .007, and HR 1.31, 95% CI 1.17-1.46, P <.001, respectively) when analyzed in separate multivariate Cox models, adjusting for baseline demographic characteristics and perioperative risk factors. However, when analyzed simultaneously in the same Cox model, cTnT was a significant predictor (HR 1.31, 95% CI 1.13-1.51, P <.001), whereas CK-MB was not (P = .99). Similar results were found when the biomarkers were analyzed together in a Cox model adjusting for European System for Cardiac Operative Risk Evaluation. The differences in mortality between the biomarker groups were consistent also when analyzing strict quartiles of peak values of CK-MB and cTnT (P = .81 and P = .001, respectively).
CONCLUSIONS: Both CK-MB and cTnT are predictors of mortality after CABG surgery; however, our data suggest that cTnT is a better predictor of long-term mortality after CABG surgery than CK-MB.
Authors:
Camilla Lund Søraas; Charlotte Friis; Kristin Victoria Tunheim Engebretsen; Leiv Sandvik; Sverre Erik Kjeldsen; Theis Tønnessen
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  164     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-09     Completed Date:  2013-01-07     Revised Date:  2013-09-19    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  779-85     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
Affiliation:
Department of Cardiology, Oslo University Hospital, Ullevaal, Oslo, Norway.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Analysis of Variance
Biological Markers / blood
Coronary Artery Bypass / mortality*
Coronary Artery Disease / mortality*,  surgery
Creatine Kinase, MB Form / blood*
Electrochemistry
Female
Humans
Kaplan-Meier Estimate
Luminescent Measurements
Male
Middle Aged
Norway / epidemiology
Postoperative Period
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Time Factors
Troponin T / blood*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Troponin T; EC 2.7.3.2/Creatine Kinase, MB Form
Comments/Corrections
Comment In:
Am Heart J. 2013 Aug;166(2):e1   [PMID:  23895824 ]
Am Heart J. 2012 Nov;164(5):636-7   [PMID:  23137492 ]
Am Heart J. 2013 Aug;166(2):e3   [PMID:  23895825 ]

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