Troponin I levels before bypass surgery after acute myocardial infarction; When to operate?
Keywords:Acute myocardial infarction, Coronary artery bypass surgery, Troponin I
Aim: Measurement of cardiac troponin I (cTnI) preop coronary artery bypass surgery (CABG) may be a determinant of surgical risk in patients with myocardial infarction (MI). Our aim is to explain the prognostic value of the preoperative serum levels of cardiac troponin I in patients with a recent acute MI under relatively stable clinical conditions.
Methods: This study was a retrospective single-center study in a small state hospital in Turkey. Included were 65 patients that had undergone a first-time isolated CABG between January 2012 and December 2014 due to acute MI. Samples for preoperative cTnI measurements were collected daily prior to the operation. Patients were enrolled in this study if they had nonST or ST elevation MI and had also undergone an early isolated CABG. We evaluated the association between serum levels of cTnI 24 hours before CABG and postoperative in-hospital patient outcomes.
Results: In cases with mortality troponin was high but it was not statistically significant. There was a significant poor positive correlation between admission troponin and intensive care unit (ICU) stay and the duration of discharge. No statically significant correlation was found between troponin levels and other postoperative in- hospital patient outcomes.
Conclusion: Although there was no significant correlation between troponin values and postoperative data troponin was higher than those without mortality. Therefore we suggest that if the vital signs are stable for patients with AMI preparing to undergo CABG, surgery should be delayed until troponin falls to nearly normal values.
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