The relationship between ASAT, CKMB, Troponin-T and mortality after cardiac surgery

Abstract

ASAT and CKMB can be used to exclude but not to diagnose permanent myocardial injury after cardiac surgery. Increased postoperative ASAT in the absence of increased TnT is not associated with worse clinical outcome than after normal postoperative ASAT.

The prognostic value of troponin release after adult cardiac surgery — a meta-analysis

“…Six of the mid-term studies [17,[26][27][28]30,31] described the completeness of their follow-up that ranged from 84% to 100%. Table 1 reports the details of the studies included.…”

“…Two studies reported on mid-term (!12 months) results [16,17], eight on short-term ( 30 days) results [18][19][20][21][22][23][24][25] and seven on both [13,[26][27][28][29][30][31], with a total of 237 mid-term deaths by any cause in 5119 patients and 296 short-term deaths by any cause in 9703 patients. Six of the mid-term studies [17,[26][27][28]30,31] described the completeness of their follow-up that ranged from 84% to 100%.…”

“…We considered the description of the troponin measurement (index test) sufficient for replication in 15 [13,[16][17][18][19][20][21][22]24,[26][27][28]30]. Sixteen [13,[16][17][18][19][20][21][22][23][24][25][26][28][29][30][31]] of 17 studies clearly described their criteria for selecting patients. Of the 12 studies that did not address in-hospital all-cause mortality, only eight described the follow-up methods (execution of the reference standard) used [13,17,26,[28][29][30].…”

Post-operative aspartate aminotransferase levels independently predict mortality after isolated coronary artery bypass grafting

“…However, other smaller and underpowered studies did not find an independent association [7][8][9]. Early studies showed that AST levels remained normal in the majority of patients after CABG [18,19].…”

“…This has occurred in part because troponins have superior sensitivity, specificity and prognostic value in this context [2][3][4][5]. However, one contemporary study reported post-operative AST levels independently predicted early and late mortality after CABG [6], but this finding has not been reproduced in other recent studies [7][8][9]. Whether AST levels are related to post-operative complications has not been previously studied.…”