[Cardiac troponin-I elevations after thoracic surgery. Incidence and correlations with baseline clinical characteristics, C-reactive protein and perioperative parameters].
OBJECTIVE
The exact incidence of cardiac troponin-I elevation after thoracic surgery and its correlation with other clinical parameters have not been fully described. The aims of this study were to determine the frequency of postoperative cardiac troponin-I elevation following lung or pleural surgery for suspected cancer, and to investigate correlations with baseline clinical characteristics, the C-reactive protein level, and perioperative parameters.


METHODS
Fifty consecutive patients were enrolled in the study. In each patient, the following parameters were measured: clinical characteristics and C-reactive protein level at baseline, cardiac troponin-I level on postoperative days 1, 3 and 5, and blood pressure, heart rate and ECG parameters every day from the day of the operation until postoperative day 5.


RESULTS
The cardiac troponin-I level was elevated postoperatively in 20% of patients. There were significant associations with either a history of coronary artery disease or the presence of more than two coronary risk factors (80% vs. 32.5%; P=.011), a history of chronic antiplatelet therapy (50% vs. 17.5%; P=.046), pneumonectomy compared with less invasive procedures (40% vs. 10%; P=.041), pericardiotomy (30% vs. 2.5%; P=.022), and transient ST-segment alterations on perioperative ECGs (60% vs. 20%; P=.02). No significant correlation was found between cardiac troponin-I elevation and the baseline C-reactive protein level.


CONCLUSIONS
Cardiac troponin-I elevation occurs frequently after thoracic surgery and it is associated with clinical markers of coronary artery disease, extensive surgical procedures, and ischemic changes observed on perioperative ECGs.
Lucreziotti
Stefano
S
División de Cardiología, Hospital Universitario S. Paolo, Milán, Italia. lucre.sp@libero.it
Conforti
Serena
S
Carletti
Francesca
F
Santaguida
Giulia
G
Meda
Stefano
S
Raveglia
Federico
F
Tundo
Fabrizio
F
Panigalli
Tiziana
T
Biondi
Maria L
ML
Mezzetti
Maurizio
M
Fiorentini
Cesare
C
D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006331:Heart Diseases / Q000097:blood*; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000601:surgery*; D008297:Male; D010997:Pleural Neoplasms / Q000097:blood* / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000097:blood*; D019210:Troponin I / Q000097:blood*
D019210:Troponin I; D002097:C-Reactive Protein