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Titolo:
Cardiac troponin I: Its contribution to the diagnosis of perioperative myocardial infarction and various complications of cardiac surgery
Autore:
Benoit, MO; Paris, M; Silleran, J; Fiemeyer, A; Moatti, N;
Indirizzi:
Hop Broussais, Biochem Lab, F-75674 Paris, France Hop Broussais Paris France F-75674 s, Biochem Lab, F-75674 Paris, France Hop Broussais, Dept Anaesthesia, F-75674 Paris, France Hop Broussais Paris France F-75674 pt Anaesthesia, F-75674 Paris, France Hop Broussais, Dept Cardiovasc Surg, F-75674 Paris, France Hop Broussais Paris France F-75674 ardiovasc Surg, F-75674 Paris, France
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 10, volume: 29, anno: 2001,
pagine: 1880 - 1886
SICI:
0090-3493(200110)29:10<1880:CTIICT>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
ARTERY BYPASS-SURGERY; COLD BLOOD CARDIOPLEGIA; CREATINE-KINASE-MB; CARDIOPULMONARY BYPASS; CRYSTALLOID CARDIOPLEGIA; CORONARY SURGERY; RISK-FACTORS; WARM BLOOD; RELEASE; REVASCULARIZATION;
Keywords:
cardiac troponin I; creatinine kinase-MB isoenzyme; perioperative myocardial infarction; cardiac surgery; valvular surgery; coronary artery bypass graft; heart failure; cardioplegia; extracorporeal circulation; non-Q-wave infarction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Benoit, MO Hop Broussais, Biochem Lab, F-75674 Paris, France Hop Broussais Paris France F-75674 Lab, F-75674 Paris, France
Citazione:
M.O. Benoit et al., "Cardiac troponin I: Its contribution to the diagnosis of perioperative myocardial infarction and various complications of cardiac surgery", CRIT CARE M, 29(10), 2001, pp. 1880-1886

Abstract

Objective: To study the value of assaying cardiac troponin I (cTnI) for the early diagnosis of perioperative myocardial infarction (PMI) and various complications of cardiac surgery. Design: A prospective observational clinical study. Setting. Biochemical laboratory, anesthesia, and cardiac surgery department of Hopital Broussais. Patients. Two hundred and sixty consecutive patients undergoing cardiac surgery. Interventions. All patients underwent coronary artery bypass grafting and/or valvular surgery under extracorporeal circulation. Per-operative and postoperative follow-up consisted of electrocardiogram, echocardiography (mainly by the transesophageal approach), and serial determinations of biochemical markers such as creatinine kinase-MB isoenzyme (CK-MB) and cTnI. PMI, new ST segment changes, and ventricular arrhythmias were considered postoperative adverse cardiac outcome. Measurements and Main Results. CTnI was measured before cardiopulmonary bypass (T-0) and 12 and 24 hrs after (T-12, T-24). CK-MB was measured on arrival in the intensive care unit and on the first postoperative day (D1). Patients were divided into three groups according to the type of surgery: coronary artery bypass graft (CABG), valvular surgery (VS), or both procedures. The plasma CK-MB and cTnI concentrations were high in all patients after extracorporeal circulation because of aortic clamping or cardioplegia. The CK-MB and cTnI values were higher in the VS group than in the CABG group. Values peaked at T-12 and fell by T-24, except when PMI occurred. Eight patients developed a PMI. Patients with PMI had significantly higher cTnI levelsat T-12 and T-24, and higher CK-MB values at DI than patients without PMI. Cutoff values of cTnI for diagnosing PMI were > 19 mug/L at T-12 with 100%sensitivity and 73% specificity, and > 36 mug/L at T-24, with 100% sensitivity and 93% specificity. Lower cTnI values were highly suggestive of the absence of PMl after CABG and/or VS. Other complications such as ST segment changes, ventricular arrhythmias and cardiac failure were indicated by highcTnI levels at T-12 and T-24, Myocardial protective measures were associated with a nonsignificant increase in cTnI values. Conclusions. CTnI is more sensitive and specific than CK-MB for diagnosingPMI and other forms of heart failure after cardiac surgery.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/09/20 alle ore 00:00:35