SurgeryUsefulness of cardiac troponin I in patients undergoing open heart surgery☆
Section snippets
Patients
During the 10-month period (5/98 to 3/99) we prospectively evaluated 100 consecutive patients referred to the San Diego Veterans Affairs Health Care System for open heart surgery and who agreed to participate in the study. Approval of consent was obtained by the University of California, San Diego, Committee on Human Subjects.
Study protocol
Blood samples (2-3 mL) were obtained from patients preoperatively and at 5 AM and 5 PM for the first 2 days after surgery. After this, blood was sampled each morning for 1
Results
Preoperative, operative, and clinical end point data are presented in Table I.Patient data (mean ± SEM) Total No. of patients 100 Preoperative ejection fraction (%) 47 ± 1.5 No. of patients with myocardial infarction <6 wk 10 Age (y) 66 ± 1.1 Average No. of vessel disease 1.8 ±.3 No. of patients with hypertension 75 No. of patients with non-insulin-dependent diabetes mellitus 31 No. of patients with insulin-dependent diabetes mellitus 8 No. of patients with
Discussion
Outcome-based medicine is becoming the accepted standard of care of patients treated for specific illnesses in our society. In the case of cardiac surgery, however, there remain few adverse measurable end points other than 30-day mortality. Although perioperative myocardial injury after cardiac surgery is an accepted clinical outcome responsible for a severalfold increase in morbidity and mortality,12, 13 there is currently no effective clinical gold standard for its detection. The ability to
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2013, International Journal of CardiologyCitation Excerpt :The post hoc power analysis revealed 98% power for the detected difference. Previous clinical studies found that peripheral blood levels of the myocardial necrosis marker cTnI increased after open heart surgery and correlated with the length of time of AXCL and CPB [27,28]. We confirmed that in our patients undergoing open heart surgery, cTnI levels increased significantly following surgery (P < 0.001, paired t-test comparing cTnI levels in each post-surgery time points with that of the pre-surgery time point) (Fig. 3).
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Reprint requests: Alan Maisel, MD, VAMC Cardiology, 3350 La Jolla Village Dr, San Diego, CA 92161. E-mail: [email protected]