Sex-based differences in serum cardiac troponin I, a specific marker for myocardial injury, after cardiac surgery.
BACKGROUND
Prevalence and causes of sex-based differences in morbidity and mortality secondary to cardiovascular disease remain controversial. Cardiac troponin I (cTnI) is a sensitive and specific marker for myocardial injury. Serial cTnI measurements have been used to identify perioperative myocardial cell injury.


OBJECTIVE
To determine whether sex influences the extent of myocardial injury during cardiac surgery, we measured perioperative cTnI in male and female patients.


METHODS
A total of 17 male and 17 female patients were prospectively studied in an age- and case-matched manner. Arterial cTnI were obtained preinduction, 30 mins after the application of the aortic cross-clamp, at arrival to the intensive care unit, and on postoperative day 1.


METHODS
Tertiary cardiac surgery center at a major teaching hospital.


RESULTS
There was no difference between men and women in body mass index (kg/m2), duration of cardiopulmonary bypass, and aortic cross-clamp times. Preoperative cTnI measurements were similar in men (0.24 +/- 0.15 ng/mL) and women (0.25 +/- 0.13 ng/mL, mean +/- sem). The maximum serum cTnI occurred on postoperative day 1 in all patients, and it was 3-fold higher in men (18.5 +/- 5.7 ng/mL) compared with women (6.4 +/- 1.0 ng/mL).


CONCLUSIONS
Men had markedly higher serum cTnI compared with women, although they were case matched with respect to age and cardiac risk factors. Our results may suggest there may be sex-related differences in the myocardial response to ischemia and reperfusion injury or intrinsic differences between the male and female myocardium.
Schwarzenberger
J C
JC
College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
Sun
Lena S
LS
Pesce
M A
MA
Heyer
E J
EJ
Delphin
E
E
Almeida
G M
GM
Wood
M
M
D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood*; D001823:Body Composition; D015992:Body Mass Index; D001830:Body Surface Area; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D016022:Case-Control Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D017202:Myocardial Ischemia / Q000097:blood* / Q000209:etiology* / Q000503:physiopathology; D015428:Myocardial Reperfusion Injury / Q000097:blood* / Q000209:etiology* / Q000503:physiopathology; D011184:Postoperative Period; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012727:Sex Characteristics; D013318:Stroke Volume; D013997:Time Factors; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I