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首页> 外文期刊>European journal of anaesthesiology >Kinetic analysis of cardiac troponin I release is no more accurate than a single 24-h measurement in predicting in-hospital outcome after cardiac surgery.
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Kinetic analysis of cardiac troponin I release is no more accurate than a single 24-h measurement in predicting in-hospital outcome after cardiac surgery.

机译：心脏肌钙蛋白I释放的动力学分析在预测心脏手术后的院内结局方面不比单次24小时测量更准确。

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BACKGROUND AND OBJECTIVE: A single cardiac troponin I (cTnI) 24-h measurement is an independent predictor of short- and long-term adverse outcome after coronary surgery. We compared a single cTnI 24-h measurement and kinetic analysis of cTnI release in predicting in-hospital outcome in unselected cardiac surgery patients. METHODS: Consecutive patients (n = 184) undergoing cardiac surgery with cardiopulmonary bypass were included and divided into two groups according to the time course of postoperative peak serum cTnI (6 or 24 h after surgery). Serial measurements of cTnI were performed the day before surgery, at the end of surgery and 6, 24 and 120 h after surgery in all patients. The total amount of cTnI released (integrated area under the curve), postoperative major adverse cardiac events (ventricular arrhythmias, myocardial infarction and congestive heart failure) and in-hospital death were recorded. Data are expressed as median (95% CI). RESULTS: In all, 152 (83%) patients had an early peak cTnI (6h after surgery) and 32 (17%) patients had a late peak cTnI (24 h after surgery). The integrated area under the curve differed between both groups: 159 (142-178) vs. 321 (255-590), respectively, P 0.001. Major adverse cardiac events and/or death (22 vs. 9%, P = 0.04) was greater in patients with a late peak cTnI. The integrated area under the curve and the peak value of cTnI were no more accurate than a single 24-h measurement in predicting the occurrence of major adverse cardiac events and/or death. CONCLUSIONS: Kinetic analysis of cTnI release was no more accurate than a single 24-h measurement in predicting in-hospital poor outcome.
机译：背景与目的：单次心脏肌钙蛋白I（cTnI）24小时测量是冠状动脉手术后短期和长期不良结局的独立预测因子。我们比较了单次cTnI 24小时测量和cTnI释放动力学分析，以预测未选定的心脏手术患者的住院结局。方法：纳入连续患者（n = 184），接受心脏体外循环心脏手术，并根据术后血清cTnI高峰时间（手术后6或24小时）分为两组。所有患者均在手术前一天，手术结束时以及手术后6、24和120小时进行cTnI的系列测量。记录释放的cTnI总量（曲线下的积分面积），术后主要不良心脏事件（室性心律失常，心肌梗塞和充血性心力衰竭）和医院内死亡。数据表示为中位数（95％CI）。结果：总共有152名患者（83％）的cTnI出现早期峰值（术后6h），而32名患者（17％）的cTnI出现了晚期峰值（术后24 h）。两组之间曲线下的积分面积不同：分别为159（142-178）和321（255-590），P <0.001。晚期cTnI峰值患者的主要不良心脏事件和/或死亡（22％vs. 9％，P = 0.04）更大。在预测主要不良心脏事件和/或死亡的发生时，曲线下的积分面积和cTnI的峰值不比单次24小时测量更准确。结论：在预测院内不良预后方面，cTnI释放的动力学分析并不比单次24小时测量更准确。

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