Prognostic value of troponin I after coronary artery bypass grafting (AMIRI-CABG study)
In 2017, the European Society of Cardiology outlined the importance of the problem of diagnosing myocardial ischemia-reperfusion injury following coronary artery bypass grafting. Myocardial injury can be accompanied by a critical decline in the cardiac index and an increase in cardiac troponin I pla...
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Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov
2021-04-01
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| Series: | Вестник трансплантологии и искусственных органов |
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| Online Access: | https://journal.transpl.ru/vtio/article/view/1320 |
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| author | N. S. Bunenkov V. V. Komok S. A. Bely A. V. Sokolov V. I. Lukashenko A. S. Nemkov G. G. Khubulava |
| author_facet | N. S. Bunenkov V. V. Komok S. A. Bely A. V. Sokolov V. I. Lukashenko A. S. Nemkov G. G. Khubulava |
| author_sort | N. S. Bunenkov |
| collection | DOAJ |
| description | In 2017, the European Society of Cardiology outlined the importance of the problem of diagnosing myocardial ischemia-reperfusion injury following coronary artery bypass grafting. Myocardial injury can be accompanied by a critical decline in the cardiac index and an increase in cardiac troponin I plasma levels. The prognostic value troponin I elevation after coronary artery bypass grafting is poorly understood. Objective: to determine the prognostic value of troponin I plasma levels in relation to a fall in the cardiac index after coronary artery bypass grafting (CABG). Task: To determine the probability the cardiac index falling below 2.2 for troponin I levels in the first hours, and on days 1, 2, 3, 4 after CABG. Materials and methods. The single-center, non-randomized prospective study, running from 2016 to 2019, included 336 patients admitted for elective surgical treatment of coronary artery disease. The CABG patients were divided into three observation groups: off-pump (n = 175), on-pump (n = 128), and pump-assisted (n = 33). Troponin I levels were measured in the first hours, and on days 1, 2, 3, 4 after surgery using the Pathfast Compact immunoassay analyzer. Cardiac index was measured by invasive method. Results. In patients with a cardiac index higher than 2.2, troponin I level did not exceed 0.5 ng/mL in the off-pump group, 6 ng/mL in the on-pump group, and 3.5 ng/mL in the pump-assisted group. Patients with cardiac index lower than 2.2 have comparable troponin I levels in all groups - 21 ng/mL. Troponin I thresholds on day 1 after surgery, which, when exceeded, was associated with the likelihood of the cardiac index falling below 2.2, was 3.78 ng/mL in the off-pump group, 9.67 ng/mL in the on-pump group and 17.06 ng/mL in the pump-assisted group. Conclusion. After off-pump CABG, clinically significant myocardial injury should be expected at lower troponin I levels (3.78 ng/mL) than after on-pump CABG (9.67 ng/mL) and pump-assisted CABG (14.7 ng/mL). |
| format | Article |
| id | doaj-art-08f4701530254fa2a565cd904a1dfe6d |
| institution | DOAJ |
| issn | 1995-1191 |
| language | Russian |
| publishDate | 2021-04-01 |
| publisher | Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov |
| record_format | Article |
| series | Вестник трансплантологии и искусственных органов |
| spelling | doaj-art-08f4701530254fa2a565cd904a1dfe6d2025-08-20T03:01:38ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovВестник трансплантологии и искусственных органов1995-11912021-04-012319110010.15825/1995-1191-2021-1-91-100961Prognostic value of troponin I after coronary artery bypass grafting (AMIRI-CABG study)N. S. Bunenkov0V. V. Komok1S. A. Bely2A. V. Sokolov3V. I. Lukashenko4A. S. Nemkov5G. G. Khubulava6Pavlov First St. Petersburg State Medical UniversityPavlov First St. Petersburg State Medical UniversityPavlov First St. Petersburg State Medical UniversityInstitute of Experimental MedicinePavlov First St. Petersburg State Medical UniversityPavlov First St. Petersburg State Medical UniversityPavlov First St. Petersburg State Medical UniversityIn 2017, the European Society of Cardiology outlined the importance of the problem of diagnosing myocardial ischemia-reperfusion injury following coronary artery bypass grafting. Myocardial injury can be accompanied by a critical decline in the cardiac index and an increase in cardiac troponin I plasma levels. The prognostic value troponin I elevation after coronary artery bypass grafting is poorly understood. Objective: to determine the prognostic value of troponin I plasma levels in relation to a fall in the cardiac index after coronary artery bypass grafting (CABG). Task: To determine the probability the cardiac index falling below 2.2 for troponin I levels in the first hours, and on days 1, 2, 3, 4 after CABG. Materials and methods. The single-center, non-randomized prospective study, running from 2016 to 2019, included 336 patients admitted for elective surgical treatment of coronary artery disease. The CABG patients were divided into three observation groups: off-pump (n = 175), on-pump (n = 128), and pump-assisted (n = 33). Troponin I levels were measured in the first hours, and on days 1, 2, 3, 4 after surgery using the Pathfast Compact immunoassay analyzer. Cardiac index was measured by invasive method. Results. In patients with a cardiac index higher than 2.2, troponin I level did not exceed 0.5 ng/mL in the off-pump group, 6 ng/mL in the on-pump group, and 3.5 ng/mL in the pump-assisted group. Patients with cardiac index lower than 2.2 have comparable troponin I levels in all groups - 21 ng/mL. Troponin I thresholds on day 1 after surgery, which, when exceeded, was associated with the likelihood of the cardiac index falling below 2.2, was 3.78 ng/mL in the off-pump group, 9.67 ng/mL in the on-pump group and 17.06 ng/mL in the pump-assisted group. Conclusion. After off-pump CABG, clinically significant myocardial injury should be expected at lower troponin I levels (3.78 ng/mL) than after on-pump CABG (9.67 ng/mL) and pump-assisted CABG (14.7 ng/mL).https://journal.transpl.ru/vtio/article/view/1320beating coronary artery bypass graftingoff-pumpon-pumppump-assistedischemia-reperfusionmyocardial injurytroponin itroponin i prognostic value |
| spellingShingle | N. S. Bunenkov V. V. Komok S. A. Bely A. V. Sokolov V. I. Lukashenko A. S. Nemkov G. G. Khubulava Prognostic value of troponin I after coronary artery bypass grafting (AMIRI-CABG study) Вестник трансплантологии и искусственных органов beating coronary artery bypass grafting off-pump on-pump pump-assisted ischemia-reperfusion myocardial injury troponin i troponin i prognostic value |
| title | Prognostic value of troponin I after coronary artery bypass grafting (AMIRI-CABG study) |
| title_full | Prognostic value of troponin I after coronary artery bypass grafting (AMIRI-CABG study) |
| title_fullStr | Prognostic value of troponin I after coronary artery bypass grafting (AMIRI-CABG study) |
| title_full_unstemmed | Prognostic value of troponin I after coronary artery bypass grafting (AMIRI-CABG study) |
| title_short | Prognostic value of troponin I after coronary artery bypass grafting (AMIRI-CABG study) |
| title_sort | prognostic value of troponin i after coronary artery bypass grafting amiri cabg study |
| topic | beating coronary artery bypass grafting off-pump on-pump pump-assisted ischemia-reperfusion myocardial injury troponin i troponin i prognostic value |
| url | https://journal.transpl.ru/vtio/article/view/1320 |
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