0
Articles |

Troponin I, Troponin T, or Creatine Kinase-MB to Detect Perioperative Myocardial Damage After Coronary Artery Bypass Surgery

Eric Bonnefoy; Sylvie Filley; Gilbert Kirkorian; Jeannine Guidollet; Ricardo Roriz; J. Robin; Paul Touboul
Author and Funding Information

Affiliations: From the Intensive Care Unit, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France,  From the Anesthesiology Department, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France,  From the Biochemistry Department, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France,  From the Cardiovascular Surgery Department, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France

Affiliations: From the Intensive Care Unit, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France,  From the Anesthesiology Department, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France,  From the Biochemistry Department, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France,  From the Cardiovascular Surgery Department, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France

Affiliations: From the Intensive Care Unit, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France,  From the Anesthesiology Department, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France,  From the Biochemistry Department, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France,  From the Cardiovascular Surgery Department, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France

Affiliations: From the Intensive Care Unit, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France,  From the Anesthesiology Department, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France,  From the Biochemistry Department, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France,  From the Cardiovascular Surgery Department, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France


1998 by the American College of Chest Physicians


Chest. 1998;114(2):482-486. doi:10.1378/chest.114.2.482
Text Size: A A A
Published online

Abstract

Study objectives: To compare cardiac troponin I (cTnI), cardiac troponin T (cTnT), and creatine kinase MB (CKMB mass) in patients with and without new Q wave on the ECG following coronary artery bypass graft (CABG) surgery.

Patients: After ethic committee's approval and informed consent, 82 patients, mean age 63±10 years, scheduled for CABG were included.

Interventions: Arterial blood samples were drawn during cardiopulmonary bypass, before, and 6, 12, 24, and 48 h after aortic cross-clamp release. cTnI, cTnT, and CKMB mass were measured. The appearance of new Q wave on the ECG performed preoperatively and 24 h postoperatively was used to assess myocardial lesion independently of biological markers.

Results: There were 69 patients without new Q wave on the ECG (group 1) and 13 with (group 2). In group 1, cTnI reached a peak of 2.1 µg/L (median, interquartile range [IQ]=2.4) at 12 h, cTnT increased progressively with a peak of 0.22 µg/L (IQ=0.2) at 48 h, and CKMB presented an earlier peak of 10 µg/L (IQ=6.2) at 6 h. Starting with the same median value, group 2 patients presented significantly higher peaks: cTnI: 17 µg/L (IQ=16) at 12 h; cTnT: 1.4 µg/L (IQ=2.3) at 12 h; and CKMB mass: 74 µg/L (IQ=61) at 6 h. Receiver operating characteristic (ROC) curves were constructed. The area under the curve was 0.90 for cTnI, 0.84 for CKMB, and 0.81 for cTnT (not significant). The best cutoff values to discriminate between group 1 and group 2 patients were determined with the ROC curves: cTnI=5 µg/L; CKMB mass=20 µg/L; cTnT=0.3 µg/L. Sensitivity, specificity, and positive and negative values for cTnI (5 µg/L) were 91%, 82%, 53%, and 98%, respectively.

Conclusions: There was little differences among cTnI, cTnT, and CKMB after CABG to diagnose myocardial damage as assessed by new Q wave on the ECG. There was a trend of cTnI to be a better discriminator than cTnT, but it did not reach statistical significance.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543