[Incidence of myocardial lesions after vascular surgery: diagnosis by troponin Ic].
OBJECTIVE
To compare the incidence of myocardial damages diagnosed following vascular surgery using the cardiac troponin I measurement technique and conventional methods.


METHODS
Prospective epidemiological study.


METHODS
Fifty-four patients who underwent surgery for either aneurysmal disease in 28 cases or occlusive aortic disease in 26 cases.


METHODS
Plasma concentration of cardiac troponin I (significant at a concentration > 1.5 ng.mL-1) was measured by immunoenzymofluorimetry on the second and fifth postoperative days. Conventional monitoring methods included daily electrocardiogram (ECG), enzymatic assay of total-PCK, and measurement of plasma levels of the MB isoenzyme of phosphokinase creatine (MB-PCK) (significant at > 1 ng.mL-1 and RI > 1.5).


RESULTS
The cardiac troponin I measurement technique allowed the diagnosis of minor myocardial damages during the postoperative period in five patients, whereas with the conventional methods (clinical signs. ECG, and MB-PCK) only three myocardial lesions were diagnosed.


CONCLUSIONS
The cardiac troponin I measurement technique allows diagnosis of minor myocardial damages following vascular surgery. Conventional methods underestimate the incidence of these damages.
Guerre-Berthelot
P
P
Département d'anesthésie et réanimation, hôpital Sainte-Marguerite, Marseille, France.
Crama
P
P
Prima
F
F
Oddoze
C
C
Branchereau
A
A
Gouin
F
F
Auffray
J P
JP
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D001018:Aortic Diseases / Q000601:surgery; D001157:Arterial Occlusive Diseases / Q000601:surgery; D015415:Biomarkers; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D019210:Troponin I / Q000097:blood*; D014656:Vascular Surgical Procedures / Q000706:statistics & numerical data*
D015415:Biomarkers; D007527:Isoenzymes; D019210:Troponin I; D003402:Creatine Kinase