Risk factors and predictive value of the triple biomarkers for myocardial infarction in non-coronary cardiac surgery
- VernacularTitle:心肌梗死三合一指标在非冠状动脉心脏手术后的影响因素和预测意义
- Author:
ZHU Jiaquan
1
;
YANG Qi
1
;
ZHANG Yunjiao
1
;
ZHANG Junwen
1
;
BAO Chunrong
1
;
DING Fangbao
1
;
MEI Ju
1
Author Information
1. Department of Cardiothoracic Surgery, Shanghai Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, 200092, P.R.China
- Publication Type:Journal Article
- Keywords:
Cardiac surgery;
cardiac troponin I;
myoglobin;
creatine kinase-MB
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2017;24(11):839-843
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the perioperative change and the predictive value of myoglobin, creatine kinase-MB (CK-MB), and cardiac troponin I (cTnI) in non-coronary cardiac surgery. Methods The clinical data of 77 patients undergoing cardiac surgery for non-coronary lesions in the Shanghai Xinhua Hospital from March 2016 to November 2016 were retrospectively reviewed, including 37 males and 40 females with a median age of 2 years. There were simple congenital heart diseases in 45 patients, complicated congenital heart diseases in 10, and heart valve diseases in 22. The levels of myoglobin, CK-MB and cTnI were collected at the first postoperative day. The ventilation duration and the length of ICU stay were recorded. The recovery condition was accessed by senior surgeons. Results The myoglobin, CK-MB and cTnI concentrations increased at the first postoperative day, and cTnI increased most significantly. The multivariate linear regression analysis indicated that these changes were only related to cardiopulmonary bypass time and aortic cross-clamping time (P<0.001). The high cTnI level was associated with prolonged ventilation duration and length of ICU stay. Fourteen patients (18.2%) did not recovered well, and their cTnI level was significantly higher than that of well-recovered patients (16.8±16.7 ng/ml vs. 5.1±4.4 ng/ml, P<0.001). The cTnI cutoff value of 5.33 ng/ml could predict whether patients had good postoperative recovery (area under the receiver operating characteristic curve=0.862, P<0.001), and the predictive value of cTnI was superior to that of myoglobin and CK-MB. Conclusion The increase levels of myoglobin, CK-MB and cTnI post non-coronary cardiac surgery are associated with prolonged cardiopulmonary bypass time and aortic cross-clamping time. cTnI on postoperative 24 h may predict good recovery, and it is a useful biomarker.
