title: Prognostic prediction of troponins in cardiac myxoma: case study with literature review.
abstract: OBJECTIVE
  It was supposed that troponins in cardiac myxoma patients might be in a same fashion as in the conditions without myocardial injury. In order to verify this hypothesis, troponins in cardiac myxoma patients were discussed by presenting a comprehensive retrieval of the literature with incorporating the information of a recent patient.
  
  
  METHODS
  Postoperative detections of troponin I, creatine kinase isoenzyme MB (CK-MB) and N-terminal pro-B-type natriuretic peptide revealed elevated troponin I and CK-MB and normal N-terminal pro-B-type natriuretic peptide. Postoperative troponin I and CK-MB shared a same trend, reaching a peak value at postoperative hour 2, gradually decreased on postoperative day 1, and reached a plateau on postoperative days 7 and 13. A significant correlation could be noted between the postoperative values of the two indicators (Y = 0.0714X + 0.6425, r2 = 0.9111, r=0.9545, P=0.0116). No significant linear correlation between troponin I and N-terminal pro-B-type natriuretic peptide were found. Literature review of troponins in cardiac myxoma patients revealed the uncomplicated patients had a normal or only slightly elevated troponin before open heart surgery. However, the complicated patients (with cerebral or cardiac events) showed a normal preoperative troponin in 3 (23.1%) and an elevated troponin in 10 (76.9%) patients (χ2 = 7.54, P = 0.0169, Fisher's exact test). The overall quantitative result of troponin I was 2.45 ± 2.53 µg/L, and that of troponin T was 3.10 ± 4.29 mg/L, respectively.
  
  
  CONCLUSIONS
  Troponins are not necessarily elevated in patients with a cardiac myxoma without coronary syndrome. By contrast, patients with a cardiac myxoma with an elevated troponin may herald the presence of an associated coronary event. An old cerebral infarct does not necessarily cause an elevation of troponin or B-type natriuretic peptide, or new neurological events, but might lead to a delayed awakening.
authors.affiliation: The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, China.
authors.forename: Shi-Min
authors.initials: SM
authors.lastname: Yuan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D052283:Creatine Kinase, MM Form / Q000097:blood; D005260:Female; D006325:Heart Atria; D006338:Heart Neoplasms / Q000737:chemistry* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000737:chemistry* / Q000601:surgery; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011184:Postoperative Period; D011379:Prognosis; D012016:Reference Values; D014336:Troponin / Q000097:blood*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D010446:Peptide Fragments; D014336:Troponin; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D052283:Creatine Kinase, MM Form