Predictive value of perioperative cardiac Troponin I for adverse outcome in coronary artery bypass surgery

Eigel, P; Ingen, Gerrit van; Wagenpfeil, Stefan

doi:10.1016/s1010-7940(01)00825-9

Cited by 59 publications

(51 citation statements)

References 12 publications

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“…The variables that were highlighted included: emergency surgery, preoperative coronary occlusion, and the first marginal artery as the target vessel, the use of short-acting nitrates, coronary angles greater than 90º in targeted segments and extended aortic clamping time. Eigel et al [9] studied predicting factors of the first occurrence of perioperative AMI (19 events) or death (six events) in MR, with the total of 21 adverse results in the 540 patients evaluated. The variables gender (female), extended aortic clamping time and extended CPB time were demonstrated to be the predictors of the result in question.…”

Section: Commentsmentioning

confidence: 99%

Fatores preditores de infarto do miocárdio no período perioperatório de cirurgia de revascularização miocárdica

Jaeger¹,

Kalil²,

Guaragna³

et al. 2005

Rev Bras Cir Cardiovasc

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Section: Commentsmentioning

confidence: 99%

Fatores preditores de infarto do miocárdio no período perioperatório de cirurgia de revascularização miocárdica

Jaeger¹,

Kalil²,

Guaragna³

et al. 2005

Rev Bras Cir Cardiovasc

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“…Its value in diagnosis of myocardial infarction is well known in clinical patients, but it is still under study in patients already grafted, [1,[3][4][5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…There is no risk of cross-reactivity of isoforms derived from the degradation of skeletal muscle, and such risk is not increased in healthy people without heart disease, even those who had undergone high muscle stress or noncardiac surgeries [3,7].…”

Section: Discussionmentioning

confidence: 99%

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Importância da troponina I no diagnóstico do infarto do miocárdio no pós-operatório de cirurgia de revascularização

Oliveira¹,

Botelho²,

Brandi³

et al. 2009

Rev Bras Cir Cardiovasc

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Importância da troponina I no diagnóstico do infarto do miocárdio no pós-operatório de cirurgia de revascularizaçãoThe importance of troponin I in the diagnosis of myocardial infarction in the postoperative of coronary artery bypass graft surgery Abstract Objective: The aim of this study is to establish a cut-off value for troponin I by correlating it to occurrence of postoperative myocardial infarction.Methods: 180 consecutive patients with coronary disease referred for surgery were included. The mean age of the patients were 60.6 (±9.3) years, with 119 (66.1%) males and 61 (33.9%) females. The patients were divided into two groups: group without myocardial infarction (A) -170 patients -and with myocardial infarction (B) -10 patients.The troponin I was collected from each patient at the beginning of anesthesia and on the second postoperative day by correlating it to presence or not of postoperative myocardial infarction. StatsDirect 1.6.0 for Windows was used for statistical analysis.Results: Preoperative troponin I was 1.0 (±6) ng/ml as mean. Univariate logistic regression showed correlation of troponin I of the second postoperative day with myocardial infarction (P=0.0005). ROC curve was used to define the cut-off value, and 6.1 ng/ml (sensitivity=90.0%, specificity=82.1%, OR=49.8 with CI=95% 6.1-410.4, P<0.0001) were found.Conclusion: The chance of a patient with postoperative myocardial infarction to present troponin I equal to or higher than 6.1 ng/ml is 49.8-fold higher than the chance of a patient without infarction to present troponin I higher than this value. Resultados: A troponina I pré-operatória apresentou uma

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“…L -1 in 24 hr). [30][31][32] Post/Pre-CPB Bcl-2 ratios were analyzed using the unpaired two-tailed Student's t test. A two-sided P \ 0.025 was considered statistically significant.…”

Section: Methodsmentioning

confidence: 99%

Propofol cardioprotection for on-pump aortocoronary bypass surgery in patients with type 2 diabetes mellitus (PRO-TECT II): a phase 2 randomized-controlled trial

Ansley

Raedschelders

Choi

et al. 2015

Can J Anesth/J Can Anesth

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Purpose The efficacy of myocardial conditioning strategies is compromised in patients with advanced age, diabetes, or low ejection fraction. We conducted a singlecentre parallel-arm blinded randomized-controlled trial to determine whether propofol provides perioperative myocardial protection. Methods Patients enrolled in this study were scheduled for primary aortocoronary bypass surgery utilizing normothermic cardiopulmonary bypass (CPB) with blood cardioplegia. The participants were stratified by diabetic status and left ventricular ejection fraction and randomly assigned to receive either an elevated dose of propofolpreviously associated with experimental cardioprotectionor an isoflurane preconditioning regime. The primary endpoint was the coronary sinus (CS) concentration of 15-F 2t -isoprostane (isoP). Secondary endpoints included inhospital low cardiac output syndrome (LCOS) and major adverse cardiac events, 12-and 24-hr CS cardiac troponin I (cTnI) release, and myocardial B-cell lymphoma 2 (Bcl-2) protein expression. Results Data were analyzed from 125 of 137 randomized participants. Participants receiving propofol experienced a greater mean (SD) increase from baseline in CS 15-F 2t -isoP levels compared with those receiving isoflurane [26.9 (10.9) pgÁmL -1 vs 12.1 (10.4) pgÁmL -1 , respectively; mean difference, 14.8; 95% confidence interval (CI), 11.0 to 18.6; P \ 0.001] but a decreased incidence of LCOS (20.9% vs 57.1%, respectively; relative risk [RR],0.37; 95% CI, 0.22 to 0.62; P \ 0.001). The incidence of LCOS was similar between groups in participants without type 2 diabetes mellitus (DM2) (P = 0.382) but significantly decreased in the propofol DM2 subgroup compared with the isoflurane DM2 subgroup (17.9% vs 70.3%, respectively; RR, 0.26; 95% CI, 0.13 to 0.52; P \ 0.001). Propofol was associated with an increase in myocardial Bcl-2 protein expression (P = 0.005), a lower incidence of a CS cTnI threshold for myocardial infarction (P = 0.014), and fewer heart failure events (P \ 0.001). Conclusion Propofol may be a preemptive intraoperative cardioprotectant for patients with DM2 under conditions of normothermic CPB and blood cardioplegic arrest. The study is registered at www.clinicaltrials.gov (NCT00734383) and www.controlled-trials.com (ISRCTN70879185). RésuméObjectif L'efficacité des stratégies de conditionnement myocardique est compromise chez les patients âgés ainsi que chez ceux atteints de diabète ou présentant une fraction d'éjection faible. Nous avons réalisé une étude randomisée contrô lée unicentrique à bras parallèles et en aveugle afin de déterminer si le propofol procurait une protection myocardique en période périopératoire. Méthode Les patients enrô lés dans cette étude devaient subir une chirurgie de pontage aorto-coronarien primaire avec circulation extracorporelle (CEC) normothermique et cardioplégie sanguine. Les participants ont été stratifiés par statut diabétique et fraction d'éjection ventriculaire gauche, puis aléatoirement répartis en deux groupes, dont l'un recevrait...

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Predictive value of perioperative cardiac Troponin I for adverse outcome in coronary artery bypass surgery

Cited by 59 publications

References 12 publications

Fatores preditores de infarto do miocárdio no período perioperatório de cirurgia de revascularização miocárdica

Fatores preditores de infarto do miocárdio no período perioperatório de cirurgia de revascularização miocárdica

Importância da troponina I no diagnóstico do infarto do miocárdio no pós-operatório de cirurgia de revascularização

Propofol cardioprotection for on-pump aortocoronary bypass surgery in patients with type 2 diabetes mellitus (PRO-TECT II): a phase 2 randomized-controlled trial

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