Abnormal elevation of myocardial necrosis biomarkers after coronary artery bypass grafting without established myocardial infarction assessed by cardiac magnetic resonance
| Autor: | Alexandre Ciappina Hueb, Carlos Alexandre Segre, José Antonio Franchini Ramires, Roberto Kalil Filho, Cesar Higa Nomura, Cibele Larrosa Garzillo, Whady Hueb, Alexandre Volney Villa, Eduardo Gomes Lima, Paulo Cury Rezende, Rodrigo Morel Vieira de Melo, Leandro Menezes Alves da Costa, Fernando Teiichi Costa Oikawa |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Periprocedural Gadolinium 030204 cardiovascular system & hematology Electrocardiography Postoperative Complications 0302 clinical medicine Troponin I Coronary bypass surgery Creatine Kinase MB Form 030212 general & internal medicine Myocardial infarction Coronary Artery Bypass medicine.diagnostic_test biology Heart General Medicine Middle Aged Magnetic Resonance Imaging Troponin Cardiac surgery Bypass surgery Cardiology cardiovascular system Female Cardiology and Cardiovascular Medicine Research Article Pulmonary and Respiratory Medicine medicine.medical_specialty lcsh:Surgery lcsh:RD78.3-87.3 Necrosis 03 medical and health sciences Cardiac magnetic resonance imaging Internal medicine medicine Humans Aged business.industry Myocardium Magnetic resonance imaging lcsh:RD1-811 medicine.disease lcsh:Anesthesiology biology.protein Surgery business IMAGEM POR RESSONÂNCIA MAGNÉTICA Biomarkers |
| Zdroj: | Journal of Cardiothoracic Surgery, Vol 12, Iss 1, Pp 1-7 (2017) Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP Journal of Cardiothoracic Surgery |
| ISSN: | 1749-8090 |
| DOI: | 10.1186/s13019-017-0684-3 |
| Popis: | The diagnosis of peri-procedural myocardial infarction is complex, especially after the emergence of high-sensitivity markers of myocardial necrosis. In this study, patients with normal baseline cardiac biomarkers and formal indication for elective on-pump coronary bypass surgery were evaluated. Electrocardiograms, cardiac biomarkers, and cardiac magnetic resonance imaging with late gadolinium enhancement were performed before and after procedures. Myocardial infarction was defined as more than ten times the upper reference limit of the 99th percentile for troponin I and for creatine kinase isoform (CK-MB) and by the findings of new late gadolinium enhancement on cardiac magnetic resonance. We assessed the release of cardiac biomarkers in patients with no evidence of myocardial infarction on cardiac magnetic resonance. Of 75 patients referred for on-pump coronary bypass surgery, 54 (100%) did not have evidence of myocardial infarction on cardiac magnetic resonance. However, all had a peak troponin I above the 99th percentile; 52 (96%) had an elevation 10 times higher than the 99th percentile. Regarding CK-MB, 54 (100%) patients had a peak CK-MB above the 99th percentile limit, and only 13 (24%) had an elevation greater than 10 times the 99th percentile. The median value of troponin I peak was 3.15 (1.2 to 3.9) ng/mL, which represented 78.7 times the 99th percentile. In this study, different from CK-MB findings, troponin was significantly increased in the absence of myocardial infarction on cardiac magnetic resonance. Thus, CK-MB was more accurate than troponin I for excluding procedure-related myocardial infarction. These data suggest a higher troponin cutoff for the diagnosis of coronary bypass surgery related myocardial infarction. http://www.isrctn.com/ISRCTN09454308 . Registered 08 May 2012. |
| Databáze: | OpenAIRE |
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