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Association of early elevated cardiac troponin I concentration and longitudinal change after off-pump coronary artery bypass grafting and adverse events: a prospective cohort study

BACKGROUND: The elevation of troponin after coronary artery bypass grafting (CABG) is common This study aimed to investigate the association between very early cardiac troponin I (cTnI) concentration and its longitudinal change within 24 hours after CABG and 30-day adverse events. METHODS: This stud...

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Autores principales: Li, Yan, Li, Yuqi, Hu, Qiuming, Zheng, Shuai, Tian, Baiyu, Meng, Fei, Chen, Zonghao, Han, Jie, Wang, Shengyu, Zhang, Haibo, Xu, Chunlei, Jia, Yixin, Jiao, Yuqing, Fu, Jintao, Meng, Xu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7711399/
https://www.ncbi.nlm.nih.gov/pubmed/33282356
http://dx.doi.org/10.21037/jtd-20-1691
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author Li, Yan
Li, Yuqi
Hu, Qiuming
Zheng, Shuai
Tian, Baiyu
Meng, Fei
Chen, Zonghao
Han, Jie
Wang, Shengyu
Zhang, Haibo
Xu, Chunlei
Jia, Yixin
Jiao, Yuqing
Fu, Jintao
Meng, Xu
author_facet Li, Yan
Li, Yuqi
Hu, Qiuming
Zheng, Shuai
Tian, Baiyu
Meng, Fei
Chen, Zonghao
Han, Jie
Wang, Shengyu
Zhang, Haibo
Xu, Chunlei
Jia, Yixin
Jiao, Yuqing
Fu, Jintao
Meng, Xu
author_sort Li, Yan
collection PubMed
description BACKGROUND: The elevation of troponin after coronary artery bypass grafting (CABG) is common This study aimed to investigate the association between very early cardiac troponin I (cTnI) concentration and its longitudinal change within 24 hours after CABG and 30-day adverse events. METHODS: This study prospectively enrolled 633 patients who underwent isolated off-pump CABG from January 2019 to May 2019. Serum cTnI levels were measured in all patients at two examinations within 24 hours postoperatively (1 hour and 12–18 hours), and a proportional hazards model was used to determine the association between cTnI levels and their change with adverse events, which were defined as a composite of 30-day mortality, stroke, heart failure, myocardial infarction (MI), and ventricular fibrillation. RESULTS: cTnI levels of the two examinations and absolute change of cTnI levels were significantly higher in the event group than in the non-event group (P<0.01, both). Earlier and later cTnI concentrations were associated with 30-day complications [adjusted hazard ration (HR) 1.598, 95% confidence interval (CI), 1.158–2.204 and HR 1.499, 95% CI, 1.228–1.831, respectively]. With regard to longitudinal change in cTnI levels, participants with persistently high levels of cTnI and those with progression from a low level to high level concentration experienced a significantly increased risk of adverse events than did participants who had a trend of persistently low cTnI levels (HR 3.105, 95% CI, 1.748–5.517 versus HR 2.944, 95% CI, 1.488–5.824). CONCLUSIONS: Longitudinal change in cTnI levels within 24 hours and early cTnI concentrations, even less than 1 hour after CABG, are associated with adverse events. These data will be useful in identifying patients at an increased risk of complications.
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spelling pubmed-77113992020-12-03 Association of early elevated cardiac troponin I concentration and longitudinal change after off-pump coronary artery bypass grafting and adverse events: a prospective cohort study Li, Yan Li, Yuqi Hu, Qiuming Zheng, Shuai Tian, Baiyu Meng, Fei Chen, Zonghao Han, Jie Wang, Shengyu Zhang, Haibo Xu, Chunlei Jia, Yixin Jiao, Yuqing Fu, Jintao Meng, Xu J Thorac Dis Original Article BACKGROUND: The elevation of troponin after coronary artery bypass grafting (CABG) is common This study aimed to investigate the association between very early cardiac troponin I (cTnI) concentration and its longitudinal change within 24 hours after CABG and 30-day adverse events. METHODS: This study prospectively enrolled 633 patients who underwent isolated off-pump CABG from January 2019 to May 2019. Serum cTnI levels were measured in all patients at two examinations within 24 hours postoperatively (1 hour and 12–18 hours), and a proportional hazards model was used to determine the association between cTnI levels and their change with adverse events, which were defined as a composite of 30-day mortality, stroke, heart failure, myocardial infarction (MI), and ventricular fibrillation. RESULTS: cTnI levels of the two examinations and absolute change of cTnI levels were significantly higher in the event group than in the non-event group (P<0.01, both). Earlier and later cTnI concentrations were associated with 30-day complications [adjusted hazard ration (HR) 1.598, 95% confidence interval (CI), 1.158–2.204 and HR 1.499, 95% CI, 1.228–1.831, respectively]. With regard to longitudinal change in cTnI levels, participants with persistently high levels of cTnI and those with progression from a low level to high level concentration experienced a significantly increased risk of adverse events than did participants who had a trend of persistently low cTnI levels (HR 3.105, 95% CI, 1.748–5.517 versus HR 2.944, 95% CI, 1.488–5.824). CONCLUSIONS: Longitudinal change in cTnI levels within 24 hours and early cTnI concentrations, even less than 1 hour after CABG, are associated with adverse events. These data will be useful in identifying patients at an increased risk of complications. AME Publishing Company 2020-11 /pmc/articles/PMC7711399/ /pubmed/33282356 http://dx.doi.org/10.21037/jtd-20-1691 Text en 2020 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Li, Yan
Li, Yuqi
Hu, Qiuming
Zheng, Shuai
Tian, Baiyu
Meng, Fei
Chen, Zonghao
Han, Jie
Wang, Shengyu
Zhang, Haibo
Xu, Chunlei
Jia, Yixin
Jiao, Yuqing
Fu, Jintao
Meng, Xu
Association of early elevated cardiac troponin I concentration and longitudinal change after off-pump coronary artery bypass grafting and adverse events: a prospective cohort study
title Association of early elevated cardiac troponin I concentration and longitudinal change after off-pump coronary artery bypass grafting and adverse events: a prospective cohort study
title_full Association of early elevated cardiac troponin I concentration and longitudinal change after off-pump coronary artery bypass grafting and adverse events: a prospective cohort study
title_fullStr Association of early elevated cardiac troponin I concentration and longitudinal change after off-pump coronary artery bypass grafting and adverse events: a prospective cohort study
title_full_unstemmed Association of early elevated cardiac troponin I concentration and longitudinal change after off-pump coronary artery bypass grafting and adverse events: a prospective cohort study
title_short Association of early elevated cardiac troponin I concentration and longitudinal change after off-pump coronary artery bypass grafting and adverse events: a prospective cohort study
title_sort association of early elevated cardiac troponin i concentration and longitudinal change after off-pump coronary artery bypass grafting and adverse events: a prospective cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7711399/
https://www.ncbi.nlm.nih.gov/pubmed/33282356
http://dx.doi.org/10.21037/jtd-20-1691
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