title: Does Postoperative Cardiac Troponin-I Have Any Prognostic Value in Predicting Midterm Mortality After Congenital Cardiac Surgery?
abstract: OBJECTIVE
  This study evaluated the prognostic value of postoperative cardiac troponin-I (cTnI) in predicting all-cause mortality up to 3 months after normothermic congenital cardiac surgery.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  All children ages 0 to 10 years.
  
  
  METHODS
  None.
  
  
  RESULTS
  cTnI was measured after the induction of anesthesia but before the surgery, at the pediatric intensive care unit arrival, and at 4, 12, and 24 hours postoperatively. Follow-up was extended up to 6 months. Overall, 169 children were analyzed, of whom 165 were survivors and 4 were nonsurvivors. cTnI levels were significantly higher in nonsurvivors only at 24 hours (p = 0.047). Children undergoing surgery with cardiopulmonary bypass (CPB) had significantly higher cTnI concentrations compared with those without CPB (p<0.001). Logistic regression analysis was performed on the 146 children in the CPB group with the following predictive variables: CPB time, postoperative cTnI concentrations, the presence of a cyanotic malformation, and intramyocardial incision. None of the variables predicted mortality. Postoperative cTnI concentrations did not predict 6 months׳ mortality. Only cTnI at 24 hours predicted the length of stay in the pediatric intensive care unit.
  
  
  CONCLUSIONS
  This study did not find that postoperative cTnI concentration predicted midterm mortality after normothermic congenital heart surgery. (ClinicalTrials.gov identifier: NCT01616394).
authors.affiliation: Department of Anesthesiology, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium. Electronic address: mona.momeni@uclouvain.be.
authors.forename: Mona
authors.initials: M
authors.lastname: Momeni
authors.affiliation: Department of Cardiac Surgery, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium.
authors.forename: Alain
authors.initials: A
authors.lastname: Poncelet
authors.affiliation: Department of Cardiac Surgery, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium.
authors.forename: Jean
authors.initials: J
authors.lastname: Rubay
authors.affiliation: Department of Anesthesiology, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium.
authors.forename: Amine
authors.initials: A
authors.lastname: Matta
authors.affiliation: Department of Anesthesiology, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium.
authors.forename: Laurent
authors.initials: L
authors.lastname: Veevaete
authors.affiliation: Pediatrics Intensive Care Unit, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Detaille
authors.affiliation: Pediatrics Intensive Care Unit, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium.
authors.forename: Laurent
authors.initials: L
authors.lastname: Houtekie
authors.affiliation: Pediatrics Intensive Care Unit, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium.
authors.forename: Stéphan
authors.initials: S
authors.lastname: Clement de Clety
authors.affiliation: Pediatrics Intensive Care Unit, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium.
authors.forename: Emilien
authors.initials: E
authors.lastname: Derycke
authors.affiliation: Department of Pediatrics, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Moniotte
authors.affiliation: Department of Pediatrics, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Sluysmans
authors.affiliation: Department of Anesthesiology, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium.
authors.forename: Francis
authors.initials: F
authors.lastname: Veyckemans
mesh_terms: D001530:Belgium / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000097:blood / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D019210:Troponin I
keywords: cardiac troponin-I; cardiopulmonary bypass; congenital heart surgery; mortality