The Perioperative Kinetics Profile of Troponin I in Lung Transplantation – A Pilot Observational Study

Andrei, Ștefan; Tran-Dinh, Alexy; Boutten, Anne; Asssadi, Maksud; Tashk, Parvine; Castier, Yves; Popescu, Bogdan A.; Bunel, Vincent; Tanaka, Sébastien; Montravers, Philippe; Augustin, Pascal

doi:10.1053/j.jvca.2022.03.026

Cited by 1 publication

(2 citation statements)

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“…The most likely explanation for this association is that hs-cTnI probably captures several factors that confer a worse prognosis after LTx, as it reflects both direct and indirect cardiac damage, as demonstrated in our study. Normal troponin kinetics after LTx consist of an early peak at 24-48 h and a progressive decline thereafter, as also noted in a study including only 10 LTx recipients [15]. However, we describe a novel association between failure to decrease hs-cTnI levels and in-hospital death, suggesting that hs-cTnI monitoring up to 72 h may be useful to identify these high-risk patients.…”

Section: Discussionsupporting

confidence: 74%

“…Normal troponin kinetics after LTx consist of an early peak at 24–48 h and a progressive decline thereafter, as also noted in a study including only 10 LTx recipients [ 15 ]. However, we describe a novel association between failure to decrease hs-cTnI levels and in-hospital death, suggesting that hs-cTnI monitoring up to 72 h may be useful to identify these high-risk patients.…”

Section: Discussionsupporting

confidence: 58%

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Implications of High Sensitivity Troponin Levels After Lung Transplantation

Rodenas-Alesina,

Luk,

Gajasan

et al. 2024

Transpl Int

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Trends in high-sensitivity cardiac troponin I (hs-cTnI) after lung transplant (LT) and its clinical value are not well stablished. This study aimed to determine kinetics of hs-cTnI after LT, factors impacting hs-cTnI and clinical outcomes. LT recipients from 2015 to 2017 at Toronto General Hospital were included. Hs-cTnI levels were collected at 0–24 h, 24–48 h and 48–72 h after LT. The primary outcome was invasive mechanical ventilation (IMV) >3 days. 206 patients received a LT (median age 58, 35.4% women; 79.6% double LT). All patients but one fulfilled the criteria for postoperative myocardial infarction (median peak hs-cTnI = 4,820 ng/mL). Peak hs-cTnI correlated with right ventricular dysfunction, >1 red blood cell transfusions, bilateral LT, use of EVLP, kidney function at admission and time on CPB or VA-ECMO. IMV>3 days occurred in 91 (44.2%) patients, and peak hs-cTnI was higher in these patients (3,823 vs. 6,429 ng/mL, p < 0.001 after adjustment). Peak hs-cTnI was higher among patients with had atrial arrhythmias or died during admission. No patients underwent revascularization. In summary, peak hs-TnI is determined by recipient comorbidities and perioperative factors, and not by coronary artery disease. Hs-cTnI captures patients at higher risk for prolonged IMV, atrial arrhythmias and in-hospital death.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionsupporting

confidence: 58%