Myocardial release of troponin T after coronary bypass surgery.
The temporal changes in cardiac S-troponin T, S-creatine kinase-MB(S-CK-MB)mass and S-myoglobin were studied for 5 days after coronary bypass grafting in 70 patients. Perioperative infarction occurred in ten patients (2 Q wave, 8 non-Q wave). All three markers showed significant increase even in patients without signs of perioperative infarction. Within 8-12 hours their levels rose significantly (p < 0.001) more in the infarction than in the non-infarction cases. Troponin T and CK-MBmass both showed early (< 8-12 h) peaks in patients with perioperative infarction. CK-MBmass returned to near normal levels within 48-72 hours, whereas troponin T remained markedly increased throughout the observation. Myoglobin concentrations varied widely among the infarction cases. In the non-infarction group, troponin T and CK-MBmass (but not myoglobin) were related to the aortic cross-clamp time. Troponin T (but not CK-MBmass) remained elevated throughout the study period in patients with longer cross-clamp times. These findings may indicate continuous release from damaged myocardium in cases of perioperative infarction. Troponin T and CK-MBmass can serve as markers of perioperative infarction and troponin T may also be useful as a marker in studies on myocardial protection.
Källner
G
G
Department of Thoracic Surgery, Karolinska Hospital, Stockholm, Sweden.
Lindblom
D
D
Forssell
G
G
Kallner
A
A
D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000097:blood; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism*; D009211:Myoglobin / Q000097:blood; D013997:Time Factors; D014336:Troponin / Q000097:blood*; D020107:Troponin T
D015415:Biomarkers; D007527:Isoenzymes; D009211:Myoglobin; D014336:Troponin; D020107:Troponin T; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D003402:Creatine Kinase