Risk stratification with troponin I in patients undergoing myocardial revascularization surgery.
OBJECTIVE
To determine the immediate behavior and the prognostic value in terms of late survival of serum troponin I measurement in patients undergoing myocardial revascularization surgery with extracorporeal circulation.


METHODS
We studied 88 random patients, 65 (73.8%) of the male sex, who underwent myocardial revascularization surgery with extracorporeal circulation. Troponin measurements were performed as follows: in the preoperative period, right after intensive care unit admission, and on the first and second postoperative days. Values below 0.1 nanogram per milliliter (ng/mL) were considered normal. The cut points for late prognostic assessment were 0.5 ng/mL; 1 ng/mL; 2.5 ng/mL; and 5 ng/mL.


RESULTS
The serum troponin I levels were elevated on the first postoperative day, suggesting the occurrence of specific myocardial damage. Patients with a poor prognosis could be identified, because the serum levels above 2.5 ng/mL and 5 ng/mL in the postoperative period resulted, respectively, in mortality rates of 33% and 50% in a maximum 6-month follow-up.


CONCLUSIONS
Troponin I values around 2.5 ng/mL in the postoperative period should call attention to the need for more aggressive diagnostic or therapeutical measures.
Leal
João Carlos Ferreira
JC
Braile Cardiocirurgia-Hospital Infante Dom Henrique da Sociedade Portuguesa de Beneficência, Brazil. joaocarlos@braile.com.br
de Paula Neto
Alfredo
A
Avanci
Luis Ernesto
LE
Braile
Maria Cristiane
MC
de Godoy
Moacir Fernandes
MF
Braile
Domingo Marcolino
DM
D015415:Biomarkers / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D005112:Extracorporeal Circulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis; D015428:Myocardial Reperfusion Injury / Q000097:blood* / Q000175:diagnosis; D009204:Myocardial Revascularization / Q000401:mortality*; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D018570:Risk Assessment; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I