MEASUREMENT OF TROPONIN I (TnI) WITH CK-MB IMPROVES DETECTION OF PERIOPERATIVE ISCHEMIA

Akhtar, Shamsuddin; Fleisher, L. A.; Rosenfeld, Brian A.; Chan, De-Chuan; Malkus, H; Weiss, J.; Brull, Sorin J.; Rosenbaum, Sverre

doi:10.1097/00000542-199809060-00060

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“…In a second abstract, Akhtar et al . [12] compared troponin I and creatine kinase‐MB levels with clinical and ECG criteria for myocardial injury in patients with known coronary artery disease or in cases in which the patients had two or more cardiac risk factors. Of the 294 patients with diagnosed myocardial injury, 38/46 had increases in troponin I and 34/46 had increases in the cardiac isoform of creatine kinase (creatine kinase‐MB).…”

Section: Discussionmentioning

confidence: 99%

Increases in serum concentrations of cardiac proteins and the prediction of early postoperative cardiovascular complications in noncardiac surgery patients

et al. 2000

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SummaryWe investigated the use of measurements of serum concentrations of the cardiac proteins troponins I and T as biochemical markers of myocardial cell damage in 80 patients undergoing vascular or major orthopaedic surgery. Holter electrocardiographic monitoring was carried out before surgery and for 3 days after surgery. Blood samples for troponins I and T and creatine kinase-MB isoenzyme were taken on each of these 4 days. Outcome was assessed at 3 months using a patient questionnaire, general practitioner follow-up and case notes review. Silent postoperative myocardial ischaemia was detected in 21 patients; increases in troponins I and T and creatine kinase-MB occurred in four, six and 17 of these patients, respectively. Eight patients suffered major postoperative complications (cardiac death, myocardial ischaemia, congestive cardiac failure, unstable angina and cerebrovascular accident) and 21 minor complications (poorly controlled hypertension needing increased or new additional treatment, palpitations, increased tiredness or shortness of breath in the absence of known respiratory disease). There were no associations between postoperative ischaemia and cardiac protein concentrations. The relative odds for the associations of major adverse outcome at 3 months after surgery and postoperative ischaemia or increased serum concentrations of the three proteins were 5.39 [95% confidence intervals 1.16±27.67] for postoperative ischaemia; 5.64 [1.07±31.00] for creatine kinase-MB isoenzyme; 17.00 [2.20±116.54] for troponin T and 13.20 [1.12±135.00] for troponin I. We found troponin T to be the only prospective marker for both major and minor cardiovascular complications (relative odds 10.65 [1.26±252.88]).

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Section: Discussionmentioning

confidence: 99%