title: Elevated cardiac markers are associated with higher mortality in patients after transjugular intrahepatic portosystemic shunt insertion.
abstract: BACKGROUND
  Transjugular intrahepatic portosystemic shunts (TIPSs) have become a widely accepted tool in the treatment of patients with symptomatic portal hypertension. The aim of our study was to assess the value of cardiac markers before and after TIPS insertion for the prediction of one-year mortality in cirrhotic patients.
  
  
  METHODS
  The study population consisted of 55 patients (38 men and 17 women, aged 55.6 ± 8.9 y, range 37-74) with liver cirrhosis treated with transjugular portosystemic shunting. Biochemical markers were measured before and 24 h after TIPS. High-sensitivity cardiac troponin T (hs-cTnT) was tested by high-sensitivity immunoassay for Elecsys analyser (Roche Diagnostics). Concentrations of creatine kinase MB isoenzyme, myoglobin (MYO), glycogenphosphorylase BB isoenzyme (GPBB) and heart type of fatty acid binding protein (FABP) were measured by the Evidence Investigator protein biochip system (Randox Laboratories).
  
  
  RESULTS
  In patients before TIPS insertion, hs-cTnT was increased above the cut-off (0.014 μg/L) in 39.2% of patients. Higher hs-cTnT and FABP concentrations were associated with poor survival in patients before TIPS (hs-cTnT: P = 0.018; FABP: P = 0.016). Twenty-four hours after the TIPS procedure, we found a significant elevation in serum GPBB in comparison with preprocedural values (P < 0.001). There was an association between postprocedural concentrations of cardiac markers (MYO, hs-cTnT, FABP) and overall survival.
  
  
  CONCLUSIONS
  Measurement of cardiac markers, mainly hs-cTnT and FABP, may be useful for mortality prediction in cirrhotic patients after TIPS. Cardiac markers are better mortality predictors than other risk factors such as age, gender or Child-Pugh score.
authors: Institute of Clinical Biochemistry and Diagnostics, Charles University, Faculty of Medicine, University Hospital, Sokolska 581, Hradec Kralove 50005. martina.vasatova@fnhk.cz
authors: Martina
authors: M
authors: Vasatova
authors: Radek
authors: R
authors: Pudil
authors: Vaclav
authors: V
authors: Safka
authors: Tomas
authors: T
authors: Fejfar
authors: Tomas
authors: T
authors: Buchler
authors: Petr
authors: P
authors: Hulek
authors: Vladimir
authors: V
authors: Palicka
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009206:Myocardium / Q000378:metabolism*; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011379:Prognosis; D012372:ROC Curve
chemical_list: D015415:Biomarkers