Troponin-T in patients with unstable and stable angina pectoris undergoing coronary bypass surgery.
BACKGROUND
Troponin-T is a sensitive indicator of minor myocardial damage during coronary bypass surgery.


METHODS
Troponin-T levels were assessed before and repeatedly for 64 hours after coronary bypass surgery in 100 patients with unstable and 100 with stable angina pectoris.


RESULTS
Postoperative troponin-T levels rose significantly within 6 hours followed by a decline until 64 hours. In unstable patients who had pain within two days and an acute myocardial infarction within two weeks before the operation (Braunwald class IIIC), Troponin-T rose to high levels that persisted for 64 h. Sixty-seven percent of these patients had an elevated troponin-T >0.10 microg/l already before the operation and a perioperative myocardial infarction was recorded in 27%. In contrast, postoperative troponin-T levels in remaining patients classified as unstable were similar to those in patients with stable angina. Elective operations in the control group were performed with a low risk of adverse postoperative events.


CONCLUSIONS
Patients with Braunwald class IIIC unstable angina suffered to a great extent myocardial cell damage following coronary bypass surgery.
Bjessmo
S
S
Department of Thoracic Surgery, Karolinska Hospital, Stockholm, Sweden. staffan.bjessmo@swipnet.se
Ivert
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000097:blood* / Q000601:surgery*; D000789:Angina, Unstable / Q000097:blood* / Q000601:surgery*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000166:cytology; D011184:Postoperative Period; D011446:Prospective Studies; D020107:Troponin T / Q000097:blood*
D020107:Troponin T