Purpose
Even in postoperative patients, cardiac troponin-I (cTnI) concentration can increase for a number of reasons. Identifying whether an increase is caused by clinically important postoperative complication such as acute myocardial infarction or by some other factor is thus of paramount importance. This study examined the cause of elevated concentration of cTnI during the early postoperative period, and compared the clinical features between patients with elevated cTnI concentration brought on by coronary artery disease (CAD) compared with those having a non-CAD cause.Methods: Postoperative cTnI concentration was measured in 3,878 patients during 30 months. We selected those patients, 155 in all, whose cTnI concentration exceeded normal value (0.78 ng/ml) more than once within seven days after surgery. The study was conducted with data collected retrospectively. We categorized patients into CAD and non-CAD group.Results: Of the 155 study subjects, 31 patients were in the CAD group and 124 were in the non-CAD group. The mean age of patients in CAD group (69.6±9.3) was older than that of non-CAD (63.6±13.9). The median value of peak cTnI concentration was higher in the CAD group. In the non-CAD group, 22 patients (17.7%) expired. Death occurred due to sepsis (21.6%), hypovolemic shock (38.1%) and arrhythmia (50%) in study subjects with elevated cTnI. There was one death in the CAD group.Conclusion: The patients with elevated postoperative cTnI concentration showed higher 28 day-mortality than those without elevation, especially in those without CAD. (J Acute Care Surg 2014;4:58-66)
E-SUBMISSION
