title: Cardiac troponin elevation predicts mortality in patients undergoing orthotopic liver transplantation.
abstract: Introduction. While patients undergoing orthotopic liver transplantation (OLT) have high cardiovascular event rates, preoperative risk stratification may not necessarily predict those susceptible patients. Troponin T (TnT) may help predict patients at risk for cardiovascular complications. Methods. Consecutive patients undergoing OLT at Mayo Clinic in Florida between 1998 and 2010 who had TnT obtained within 10 days following surgery were included. Three groups were compared based on TnT level: (1) normal (TnT ≤0.01 ng/mL), (2) intermediate (TnT 0.02-0.11 ng/mL), and (3) elevated (TnT >0.11 ng/mL). Overall and cardiovascular mortality was assessed. Results. Of the 78 patients included, there was no difference in age, gender, severity of liver disease, and echocardiographic findings. Patients in the normal and intermediate TnT groups had a lower overall mortality rate (14.3% and 0%, resp.) when compared with those with elevated TnT (50%; P = 0.001). Patients in the elevated TnT group had a cardiovascular mortality rate of 37.5% compared with 1.4% in the other groups combined (P < 0.01). The elevated TnT group had a much higher mortality rate when compared with those in the intermediate group (P < 0.0001). Conclusion. TnT may accurately help risk stratify patients in the early postoperative setting to better predict cardiovascular complications.
authors: Department of Medicine, Mayo Clinic, Jacksonville, FL, USA.
authors: David
authors: D
authors: Snipelisky
authors: Sean
authors: S
authors: Donovan
authors: Michael
authors: M
authors: Levy
authors: Raj
authors: R
authors: Satyanarayana
authors: Brian
authors: B
authors: Shapiro
references: Heart. 2002 Jan;87(1):9-15
references: 11751653
references: N Engl J Med. 2009 Aug 27;361(9):868-77
references: 19710485
references: Hepatology. 2007 Jun;45(6):1489-95
references: 17538968
references: Liver Transpl. 2011 Jan;17(1):23-31
references: 21254341
references: Liver Transpl Surg. 1996 Nov;2(6):426-30
references: 9346688
references: Liver Transpl. 2001 Sep;7(9):755-61
references: 11552207
references: Hepatology. 1999 Mar;29(3):640-3
references: 10051461
references: Am J Transplant. 2010 Jun;10(6):1420-7
references: 20486907
references: Heart. 2002 Oct;88(4):343-7
references: 12231588
references: Circulation. 1993 Jul;88(1):101-6
references: 8319322