Loading…

Clinical Relevance of Troponin T Profile Following Cardiac Surgery

Peak post-operative cardiac troponin T (cTnT) independently predicts mid- and long-term outcome of cardiac surgery patients. A few studies however have reported two peaks of cTnT over the first 48-72 h following myocardial reperfusion. The aim of the current study was to better understand underlying...

Full description

Saved in:
Bibliographic Details
Published in:Frontiers in cardiovascular medicine 2018-12, Vol.5, p.182-182
Main Authors: Tevaearai Stahel, Hendrik T, Do, Peter D, Klaus, Jeremias Bendicht, Gahl, Brigitta, Locca, Didier, Göber, Volkhard, Carrel, Thierry P
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c459t-b21e0b4df24eceba9259ac5e65ebe80a42614a1dbfa82441f111fe14c3f007433
cites cdi_FETCH-LOGICAL-c459t-b21e0b4df24eceba9259ac5e65ebe80a42614a1dbfa82441f111fe14c3f007433
container_end_page 182
container_issue
container_start_page 182
container_title Frontiers in cardiovascular medicine
container_volume 5
creator Tevaearai Stahel, Hendrik T
Do, Peter D
Klaus, Jeremias Bendicht
Gahl, Brigitta
Locca, Didier
Göber, Volkhard
Carrel, Thierry P
description Peak post-operative cardiac troponin T (cTnT) independently predicts mid- and long-term outcome of cardiac surgery patients. A few studies however have reported two peaks of cTnT over the first 48-72 h following myocardial reperfusion. The aim of the current study was to better understand underlying reasons of these different cTnT profiles and their possible relevance in terms of clinical outcome. All consecutive adult cardiac surgical procedures performed with an extra-corporeal circulation during a >6 years period were retrospectively evaluated. Patients with a myocardial infarction (MI) < 8 days were excluded. cTnT profile of patients with at least one value ≥1 ng/mL value were categorized according to the time occurrence of the peak value. Univariable and multivariable analysis were performed to identify factors influencing early vs. late increase of cTnT values, and to verify the correlation of early vs. late increase with clinical outcome. Data of 5,146 patients were retrieved from our prospectively managed registry. From 953 with at least one cTnT value ≥1 ng/mL, peak occurred ≤ 6 h ( = 22), >6 to ≤ 12 h ( = 366), >12 to ≤ 18 h ( = 176), >18 to ≤ 24 h (171), >24 h (218). Age (OR: 1.023; CI: 1.016-1.030) and isolated CABG (OR: 1.779; CI: 1.114-2.839) were independent predictors of a late increase of cTnT over a limit of 1 ng/ml ( < 0.05), whereas isolated valve procedures (OR: 0.685; CI: 0.471-0.998) and cross-clamp duration (OR: 0.993; CI: 0.990-0.997) independently predicted an early elevation ( < 0.05). Delayed elevation as opposed to early elevation correlated with a higher rate of post-operative complications including MI (19.8 vs. 7.2%), new renal insufficiency (16.3 vs. 6.7%), MACCE (32.0 vs. 15.5%), or death (7.4 vs. 4.4%). Profile of cTnT elevation following cardiac surgery depends on patients' intrinsic factors, type of surgery and duration of cross-clamp time. Delayed increase is of higher clinically relevance than prompt post-operative elevation.
doi_str_mv 10.3389/fcvm.2018.00182
format article
fullrecord <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_9b2f22658783452283f26897f22513e1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_9b2f22658783452283f26897f22513e1</doaj_id><sourcerecordid>2165040888</sourcerecordid><originalsourceid>FETCH-LOGICAL-c459t-b21e0b4df24eceba9259ac5e65ebe80a42614a1dbfa82441f111fe14c3f007433</originalsourceid><addsrcrecordid>eNpVkU1LAzEQhoMoKurZm-zRS2smH9vkImixKgiKVvAWstlJjaSbmm0r_nu3rYpeMmHmzTOBh5BjoH3OlT7zbjntMwqqT7uDbZF9xvSgR6V82f5z3yNHbftGu4wUSpZql-xxWoJWSu-Ty2EMTXA2Fo8YcWkbh0XyxTinWWpCU4yLh5x8iFiMUozpIzSTYmhzHawrnhZ5gvnzkOx4G1s8-q4H5Hl0NR7e9O7ur2-HF3c9J6Se9yoGSCtReybQYWU1k9o6iaXEChW1gpUgLNSVt4oJAR4APIJw3FM6EJwfkNsNt072zcxymNr8aZINZt1IeWJsngcX0eiKecZKqQaKC8mY4p6VSg-6pgSO0LHON6zZoppi7bCZZxv_Qf9PmvBqJmlpSk4BlOoAp9-AnN4X2M7NNLQOY7QNpkVrGJSSCqrW0bNN1OXUthn97xqgZiXSrESalUizFtm9OPn7u9_8jzb-BfG9mRA</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2165040888</pqid></control><display><type>article</type><title>Clinical Relevance of Troponin T Profile Following Cardiac Surgery</title><source>PubMed (Medline)</source><creator>Tevaearai Stahel, Hendrik T ; Do, Peter D ; Klaus, Jeremias Bendicht ; Gahl, Brigitta ; Locca, Didier ; Göber, Volkhard ; Carrel, Thierry P</creator><creatorcontrib>Tevaearai Stahel, Hendrik T ; Do, Peter D ; Klaus, Jeremias Bendicht ; Gahl, Brigitta ; Locca, Didier ; Göber, Volkhard ; Carrel, Thierry P</creatorcontrib><description>Peak post-operative cardiac troponin T (cTnT) independently predicts mid- and long-term outcome of cardiac surgery patients. A few studies however have reported two peaks of cTnT over the first 48-72 h following myocardial reperfusion. The aim of the current study was to better understand underlying reasons of these different cTnT profiles and their possible relevance in terms of clinical outcome. All consecutive adult cardiac surgical procedures performed with an extra-corporeal circulation during a &gt;6 years period were retrospectively evaluated. Patients with a myocardial infarction (MI) &lt; 8 days were excluded. cTnT profile of patients with at least one value ≥1 ng/mL value were categorized according to the time occurrence of the peak value. Univariable and multivariable analysis were performed to identify factors influencing early vs. late increase of cTnT values, and to verify the correlation of early vs. late increase with clinical outcome. Data of 5,146 patients were retrieved from our prospectively managed registry. From 953 with at least one cTnT value ≥1 ng/mL, peak occurred ≤ 6 h ( = 22), &gt;6 to ≤ 12 h ( = 366), &gt;12 to ≤ 18 h ( = 176), &gt;18 to ≤ 24 h (171), &gt;24 h (218). Age (OR: 1.023; CI: 1.016-1.030) and isolated CABG (OR: 1.779; CI: 1.114-2.839) were independent predictors of a late increase of cTnT over a limit of 1 ng/ml ( &lt; 0.05), whereas isolated valve procedures (OR: 0.685; CI: 0.471-0.998) and cross-clamp duration (OR: 0.993; CI: 0.990-0.997) independently predicted an early elevation ( &lt; 0.05). Delayed elevation as opposed to early elevation correlated with a higher rate of post-operative complications including MI (19.8 vs. 7.2%), new renal insufficiency (16.3 vs. 6.7%), MACCE (32.0 vs. 15.5%), or death (7.4 vs. 4.4%). Profile of cTnT elevation following cardiac surgery depends on patients' intrinsic factors, type of surgery and duration of cross-clamp time. Delayed increase is of higher clinically relevance than prompt post-operative elevation.</description><identifier>ISSN: 2297-055X</identifier><identifier>EISSN: 2297-055X</identifier><identifier>DOI: 10.3389/fcvm.2018.00182</identifier><identifier>PMID: 30619889</identifier><language>eng</language><publisher>Switzerland: Frontiers Media S.A</publisher><subject>CABG ; cardiac biomarkers ; cardiac surgery ; Cardiovascular Medicine ; complications ; troponin</subject><ispartof>Frontiers in cardiovascular medicine, 2018-12, Vol.5, p.182-182</ispartof><rights>Copyright © 2018 Tevaearai Stahel, Do, Klaus, Gahl, Locca, Göber and Carrel. 2018 Tevaearai Stahel, Do, Klaus, Gahl, Locca, Göber and Carrel</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-b21e0b4df24eceba9259ac5e65ebe80a42614a1dbfa82441f111fe14c3f007433</citedby><cites>FETCH-LOGICAL-c459t-b21e0b4df24eceba9259ac5e65ebe80a42614a1dbfa82441f111fe14c3f007433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301188/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301188/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30619889$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tevaearai Stahel, Hendrik T</creatorcontrib><creatorcontrib>Do, Peter D</creatorcontrib><creatorcontrib>Klaus, Jeremias Bendicht</creatorcontrib><creatorcontrib>Gahl, Brigitta</creatorcontrib><creatorcontrib>Locca, Didier</creatorcontrib><creatorcontrib>Göber, Volkhard</creatorcontrib><creatorcontrib>Carrel, Thierry P</creatorcontrib><title>Clinical Relevance of Troponin T Profile Following Cardiac Surgery</title><title>Frontiers in cardiovascular medicine</title><addtitle>Front Cardiovasc Med</addtitle><description>Peak post-operative cardiac troponin T (cTnT) independently predicts mid- and long-term outcome of cardiac surgery patients. A few studies however have reported two peaks of cTnT over the first 48-72 h following myocardial reperfusion. The aim of the current study was to better understand underlying reasons of these different cTnT profiles and their possible relevance in terms of clinical outcome. All consecutive adult cardiac surgical procedures performed with an extra-corporeal circulation during a &gt;6 years period were retrospectively evaluated. Patients with a myocardial infarction (MI) &lt; 8 days were excluded. cTnT profile of patients with at least one value ≥1 ng/mL value were categorized according to the time occurrence of the peak value. Univariable and multivariable analysis were performed to identify factors influencing early vs. late increase of cTnT values, and to verify the correlation of early vs. late increase with clinical outcome. Data of 5,146 patients were retrieved from our prospectively managed registry. From 953 with at least one cTnT value ≥1 ng/mL, peak occurred ≤ 6 h ( = 22), &gt;6 to ≤ 12 h ( = 366), &gt;12 to ≤ 18 h ( = 176), &gt;18 to ≤ 24 h (171), &gt;24 h (218). Age (OR: 1.023; CI: 1.016-1.030) and isolated CABG (OR: 1.779; CI: 1.114-2.839) were independent predictors of a late increase of cTnT over a limit of 1 ng/ml ( &lt; 0.05), whereas isolated valve procedures (OR: 0.685; CI: 0.471-0.998) and cross-clamp duration (OR: 0.993; CI: 0.990-0.997) independently predicted an early elevation ( &lt; 0.05). Delayed elevation as opposed to early elevation correlated with a higher rate of post-operative complications including MI (19.8 vs. 7.2%), new renal insufficiency (16.3 vs. 6.7%), MACCE (32.0 vs. 15.5%), or death (7.4 vs. 4.4%). Profile of cTnT elevation following cardiac surgery depends on patients' intrinsic factors, type of surgery and duration of cross-clamp time. Delayed increase is of higher clinically relevance than prompt post-operative elevation.</description><subject>CABG</subject><subject>cardiac biomarkers</subject><subject>cardiac surgery</subject><subject>Cardiovascular Medicine</subject><subject>complications</subject><subject>troponin</subject><issn>2297-055X</issn><issn>2297-055X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpVkU1LAzEQhoMoKurZm-zRS2smH9vkImixKgiKVvAWstlJjaSbmm0r_nu3rYpeMmHmzTOBh5BjoH3OlT7zbjntMwqqT7uDbZF9xvSgR6V82f5z3yNHbftGu4wUSpZql-xxWoJWSu-Ty2EMTXA2Fo8YcWkbh0XyxTinWWpCU4yLh5x8iFiMUozpIzSTYmhzHawrnhZ5gvnzkOx4G1s8-q4H5Hl0NR7e9O7ur2-HF3c9J6Se9yoGSCtReybQYWU1k9o6iaXEChW1gpUgLNSVt4oJAR4APIJw3FM6EJwfkNsNt072zcxymNr8aZINZt1IeWJsngcX0eiKecZKqQaKC8mY4p6VSg-6pgSO0LHON6zZoppi7bCZZxv_Qf9PmvBqJmlpSk4BlOoAp9-AnN4X2M7NNLQOY7QNpkVrGJSSCqrW0bNN1OXUthn97xqgZiXSrESalUizFtm9OPn7u9_8jzb-BfG9mRA</recordid><startdate>20181213</startdate><enddate>20181213</enddate><creator>Tevaearai Stahel, Hendrik T</creator><creator>Do, Peter D</creator><creator>Klaus, Jeremias Bendicht</creator><creator>Gahl, Brigitta</creator><creator>Locca, Didier</creator><creator>Göber, Volkhard</creator><creator>Carrel, Thierry P</creator><general>Frontiers Media S.A</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20181213</creationdate><title>Clinical Relevance of Troponin T Profile Following Cardiac Surgery</title><author>Tevaearai Stahel, Hendrik T ; Do, Peter D ; Klaus, Jeremias Bendicht ; Gahl, Brigitta ; Locca, Didier ; Göber, Volkhard ; Carrel, Thierry P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-b21e0b4df24eceba9259ac5e65ebe80a42614a1dbfa82441f111fe14c3f007433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>CABG</topic><topic>cardiac biomarkers</topic><topic>cardiac surgery</topic><topic>Cardiovascular Medicine</topic><topic>complications</topic><topic>troponin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tevaearai Stahel, Hendrik T</creatorcontrib><creatorcontrib>Do, Peter D</creatorcontrib><creatorcontrib>Klaus, Jeremias Bendicht</creatorcontrib><creatorcontrib>Gahl, Brigitta</creatorcontrib><creatorcontrib>Locca, Didier</creatorcontrib><creatorcontrib>Göber, Volkhard</creatorcontrib><creatorcontrib>Carrel, Thierry P</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Frontiers in cardiovascular medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tevaearai Stahel, Hendrik T</au><au>Do, Peter D</au><au>Klaus, Jeremias Bendicht</au><au>Gahl, Brigitta</au><au>Locca, Didier</au><au>Göber, Volkhard</au><au>Carrel, Thierry P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Relevance of Troponin T Profile Following Cardiac Surgery</atitle><jtitle>Frontiers in cardiovascular medicine</jtitle><addtitle>Front Cardiovasc Med</addtitle><date>2018-12-13</date><risdate>2018</risdate><volume>5</volume><spage>182</spage><epage>182</epage><pages>182-182</pages><issn>2297-055X</issn><eissn>2297-055X</eissn><abstract>Peak post-operative cardiac troponin T (cTnT) independently predicts mid- and long-term outcome of cardiac surgery patients. A few studies however have reported two peaks of cTnT over the first 48-72 h following myocardial reperfusion. The aim of the current study was to better understand underlying reasons of these different cTnT profiles and their possible relevance in terms of clinical outcome. All consecutive adult cardiac surgical procedures performed with an extra-corporeal circulation during a &gt;6 years period were retrospectively evaluated. Patients with a myocardial infarction (MI) &lt; 8 days were excluded. cTnT profile of patients with at least one value ≥1 ng/mL value were categorized according to the time occurrence of the peak value. Univariable and multivariable analysis were performed to identify factors influencing early vs. late increase of cTnT values, and to verify the correlation of early vs. late increase with clinical outcome. Data of 5,146 patients were retrieved from our prospectively managed registry. From 953 with at least one cTnT value ≥1 ng/mL, peak occurred ≤ 6 h ( = 22), &gt;6 to ≤ 12 h ( = 366), &gt;12 to ≤ 18 h ( = 176), &gt;18 to ≤ 24 h (171), &gt;24 h (218). Age (OR: 1.023; CI: 1.016-1.030) and isolated CABG (OR: 1.779; CI: 1.114-2.839) were independent predictors of a late increase of cTnT over a limit of 1 ng/ml ( &lt; 0.05), whereas isolated valve procedures (OR: 0.685; CI: 0.471-0.998) and cross-clamp duration (OR: 0.993; CI: 0.990-0.997) independently predicted an early elevation ( &lt; 0.05). Delayed elevation as opposed to early elevation correlated with a higher rate of post-operative complications including MI (19.8 vs. 7.2%), new renal insufficiency (16.3 vs. 6.7%), MACCE (32.0 vs. 15.5%), or death (7.4 vs. 4.4%). Profile of cTnT elevation following cardiac surgery depends on patients' intrinsic factors, type of surgery and duration of cross-clamp time. Delayed increase is of higher clinically relevance than prompt post-operative elevation.</abstract><cop>Switzerland</cop><pub>Frontiers Media S.A</pub><pmid>30619889</pmid><doi>10.3389/fcvm.2018.00182</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 2297-055X
ispartof Frontiers in cardiovascular medicine, 2018-12, Vol.5, p.182-182
issn 2297-055X
2297-055X
language eng
recordid cdi_doaj_primary_oai_doaj_org_article_9b2f22658783452283f26897f22513e1
source PubMed (Medline)
subjects CABG
cardiac biomarkers
cardiac surgery
Cardiovascular Medicine
complications
troponin
title Clinical Relevance of Troponin T Profile Following Cardiac Surgery
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T13%3A47%3A14IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Clinical%20Relevance%20of%20Troponin%20T%20Profile%20Following%20Cardiac%20Surgery&rft.jtitle=Frontiers%20in%20cardiovascular%20medicine&rft.au=Tevaearai%20Stahel,%20Hendrik%20T&rft.date=2018-12-13&rft.volume=5&rft.spage=182&rft.epage=182&rft.pages=182-182&rft.issn=2297-055X&rft.eissn=2297-055X&rft_id=info:doi/10.3389/fcvm.2018.00182&rft_dat=%3Cproquest_doaj_%3E2165040888%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c459t-b21e0b4df24eceba9259ac5e65ebe80a42614a1dbfa82441f111fe14c3f007433%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2165040888&rft_id=info:pmid/30619889&rfr_iscdi=true