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High-sensitivity troponin T levels before and after cardiac surgery and the 30-day mortality: a retrospective cohort study.
Liang, Jian-Wei; Zhou, Min; Jin, Yong-Qiang; Li, Ting-Ting; Wen, Jiang-Ping.
Afiliación
  • Liang JW; Laboratory Medicine Department, Tsinghua University First Hospital, Beijing, China.
  • Zhou M; Obstetrics and Gynecology Department, Tsinghua University First Hospital, Beijing, China.
  • Jin YQ; Department of Medical Laboratory, Tianjin Medical University, Tianjin, China.
  • Li TT; Laboratory Medicine Department, Tsinghua University First Hospital, Beijing, China.
  • Wen JP; Laboratory Medicine Department, Tsinghua University First Hospital, Beijing, China.
Front Cardiovasc Med ; 10: 1276035, 2023.
Article en En | MEDLINE | ID: mdl-38099226
ABSTRACT

Background:

The suggested threshold level of cardiac troponin T elevation after cardiac surgery is not very clear, and the values recommended by various guidelines and literature reports are quite different.

Methods:

In this retrospective cohort study, we collected clinical data of patients who underwent heart surgery at Tsinghua University First Hospital between January 2015 and December 2022. Using the high-sensitivity cardiac troponin T levels (reference upper limit 14 ng/L) measured at 1-3 days postoperation, the relationship between the cardiac troponin T level and the 30-day mortality risk was evaluated using Cox regression analysis.

Results:

Among the 3,128 patients included in this study, the types of operations mainly consisted of coronary artery bypass graft (CABG, 1,164, 37.2%), aortic valve replacement (AVR, 735, 23.5%), and other cardiac operations (1,229, 39.3%). Within 30 days postoperation, 57 patients (1.8%) died and 72 patients (2.3%) developed major vascular complications. In patients undergoing CABG or AVR, the cardiac troponin T threshold level measured within one day postoperation related to an increased 30-day mortality was determined to be 3,012 ng/L (95% CI 1,435-3,578 ng/L), which is 218 times higher than the reference upper limit. In patients undergoing other cardiac operations, this threshold was 5,876 ng/L (95% CI 2,458-8,119 ng/L), which is 420 times higher than the reference upper limit.

Conclusion:

The high-sensitivity cardiac troponin T level associated with an increased 30-day mortality risk after cardiac surgery is significantly higher than the current recommendations for defining clinically important perioperative myocardial injury.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Cardiovasc Med Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Cardiovasc Med Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Suiza