Myocardial necrosis biomarkers after different cardiac surgical operations.
OBJECTIVE
A high postoperative peak of cardiac Troponin I is associated to an increased risk of morbidity and mortality after cardiac operations. The aim of this study was to investigate the release of cardiac Troponin I in different cardiac surgical procedures.


METHODS
This was a prospective, single-centre study performed at the IRCCS San Raffaele Hospital in Milan, Italy. The study group consisted of 194 consecutive patients undergoing cardiac surgery. For each of them creatinkinase MB and cardiac Troponin I were assayed preoperatively, at ICU arrival, 4 h and 18 h postoperatively.


RESULTS
Different cardiac surgical procedures were characterized by different release of cardiac biomarkers (P<0.001, ANOVA test). Off-pump coronary artery bypass grafting (CABG) was associated to the smallest amount of myocardial injury while mitral valve replacement produced the largest amount of biomarkers release. Patients who suffered a postoperative cardiac event released more myocardial necrosis biomarkers than those with an uneventful course (P=0.01).


CONCLUSIONS
We showed that each type of cardiac operation has a peculiar amount of myocardial necrosis biomarkers: mitral valve replacement in particular is associated to the highest release of cardiac biomarkers.
Landoni
G
G
Department of Cardiovascular Anesthesia, and Intensive Care, Vita-Salute University, IRCCS San Raffaele Hospital, Milan, Italy.
Pappalardo
F
F
Calabrò
M G
MG
Boroli
F
F
Sottocorna
O
O
Aletti
G
G
Crescenzi
G
G
Zangrillo
A
A
D000368:Aged; D000758:Anesthesia; D015415:Biomarkers; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003402:Creatine Kinase / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D009336:Necrosis; D011184:Postoperative Period; D011446:Prospective Studies; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I; D003402:Creatine Kinase