The Prognostic Role of Early Postoperative Troponin I in Lung Transplantation—A Retrospective 7-Year Analysis

Implications of High Sensitivity Troponin Levels After Lung Transplantation

“…The fourth universal definition of MI defines a type V MI as a CABG-related MI, leaving all other postoperative, nonrevascularization related MI within a separate category poorly characterized [12]. Within 72 h after LTx, 99.5% of our population had an elevated hs-cTnI >10 times above the 99th percentile, as documented before [9]. There were no coronary plaque ruptures documented, no significant CAD before surgery, no need for revascularization during hospital admission and no correlation with left ventricular ejection fraction, suggesting that hs-cTnI rise is explained by factors related to the surgical intervention and the postoperative course, especially since the LTx operation necessitates cutting and sewing the atrial myocardium, and the rise in hs-cTnI does not reflect coronary artery disease.…”

“…Another study described the impact on 30 days and 1-year mortality of a single hs-cTnI measurement upon admission to the ICU. The authors also described an association between a higher troponin and mortality [ 9 ]. The association between peak hs-cTnI and worse outcomes is well described in both cardiac and non-cardiac surgery.…”

“…The use of hs-cTnI in the lung transplant (LTx) population has not been well studied. During LTx, hemodynamic stability and direct cardiac damage may confer a different value to hs-cTnI to that of non-cardiac surgery, but there is paucity of data regarding the elevation of hs-cTnI in the early postoperative course of LTx recipients, limited by sample size and lack of serial measurements [ 8 , 9 ]. With the new hs-cTnI assays replacing the old ones, it remains crucial to examine the normal trend in hs-cTnI in LTx to guide decision-making.…”