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The Journal of Cardiovascular Surgery 2001 December;42(6):709-12

language: English

Troponin as a marker of myocardial damage during coronary surgery with and without cardiopulmonary bypass

Piacenza A. E., Cacheda J. H., Badaracco J. R., Benetti F. J.

From the Cardiovascular Surgery Department Instituto de Cardiologia de Corrientes “J. F. Cabral”, Corrientes, Argentina


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Background. The use of cor­o­nary sur­gery with­out car­di­o­pul­mo­nary ­bypass (CBP) has ­been grow­ing dur­ing the ­last ­years. In ­order to com­pare myo­car­dial dam­age dur­ing cor­o­nary sur­gery ­with and with­out CBP, per­i­op­er­a­tive Troponin T deter­mi­na­tions ­were ­done.
Methods. Experimental ­design and set­ting: pros­pec­tive, com­par­a­tive. Cardiovascular sur­gery depart­ment. Patients, inter­ven­tions and meas­ures: 29 pros­pec­tive ­patients who under­went elec­tive cor­o­nary sur­gery ­were ­enrolled. Troponin T deter­mi­na­tions (ng/ml) ­were ­done ­before sur­gi­cal pro­ce­dure, ­after a 2-­hour and ­after a 12-­hour post­op­er­a­tive. Population was divid­ed in two ­groups: group 1, ­with CBP (17 ­patients); group 2, with­out CBP (12 ­patients). Variables in rela­tion ­with pop­u­la­tion char­ac­ter­is­tics, myo­car­dial dam­age and imme­di­ate post­op­er­a­tive hae­mod­y­nam­ic ­results ­were all ana­lyzed.
Results. Population char­ac­ter­is­tics and ­basal Troponin lev­els ­were sim­i­lar for the two ­groups. Troponin T aver­age lev­els at 2-hour post­op­er­a­tive peri­od was 0.729 ng/ml and 0.067 ng/ml for ­group 1 and 2, respec­tive­ly (p<0.00002). At 12 ­hours post­op­er­a­tive peri­od Troponin T was 1.047 ng/ml and 0.183 ng/ml for ­group ­land 2 (p<0.0002). Haemodynamic per­for­mance was bet­ter in the ­group with­out CBP.
Conclusions. Troponin T lev­els ­were sig­nif­i­cant­ly ele­vat­ed in ­group 1, show­ing ­that sur­gi­cal pro­ce­dures with­out CBP ­caused ­less myo­car­dial dam­age.

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