Perioperative Cardiac Troponin T and Risk of Postoperative Atrial Fibrillation in Coronary Artery Bypass Graft Surgery.

Q3 Medicine Critical Pathways in Cardiology Pub Date : 2022-03-01 DOI:10.1097/HPC.0000000000000276

Ali Vasheghani Farahani, Abbas Salehi Omran, Kyomars Abbasi, Ali Gholamrezaei, Pejman Mansouri, Seyed Hossein Ahmadi Tafti, Mansour Jahangiri

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Abstract

Background: Postoperative atrial fibrillation (AF) is a common complication after cardiac surgery. We investigated whether perioperative cardiac troponin T (cTnT) is associated with the risk of AF after coronary artery bypass grafting (CABG).

Methods: Two thousand four hundred twenty-one patients with isolated CABG were studied. High sensitivity cTnT (hs-cTnT) was assessed before and then at 80 hour and 24 hour after the operation. Logistic regression models were applied to investigate the association of perioperative hs-cTnT with postoperative AF. The ROC curve analysis was applied to determine the optimal cutoff values.

Results: Postoperative AF was occurred in 356 (14.7%) patients. Age (adjusted odds ratio [ORs] 1.087-1.090), male gender (OR 1.390), left atrium size (ORs 1.055-1.111), on-pump coronary bypass (OR 1.561), and application of intra-aortic balloon pump (ORs 2.890-2.966) were independently associated with AF. Preoperative hs-cTnT was associated with AF in patients with off-pump coronary bypass (ORs 1.997-2.375). However, the area under the curve for preoperative hs-cTnT was 0.625 in this group. On-pump coronary bypass had major influence on postoperative hs-cTnT levels regardless of the occurrence of AF.

Conclusions: Preoperative hs-cTnT level is associated with the risk of AF after isolated CABG in patients undergoing off-pump coronary bypass, but the accuracy of this biomarker is yet inadequate. Postoperative levels of hs-cTnT have no predictive value considering large influence by the surgical technique and the cardiac surgery itself. Therefore, perioperative hs-cTnT is not a clinically useful biomarker for predicting AF following CABG.

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围术期心肌肌钙蛋白T与冠状动脉搭桥术术后房颤的风险

背景:术后心房颤动(AF)是心脏手术后常见的并发症。我们研究了围手术期心肌肌钙蛋白T (cTnT)是否与冠状动脉旁路移植术(CABG)后房颤的风险相关。方法:对2421例孤立性冠脉搭桥患者进行分析。术前、术后80小时和24小时分别评估高灵敏度cTnT (hs-cTnT)。采用Logistic回归模型探讨围手术期hs-cTnT与术后房颤的关系，采用ROC曲线分析确定最佳截断值。结果:术后发生房颤356例(14.7%)。年龄(校正优势比[OR] 1.087-1.090)、男性(OR 1.390)、左心房大小(OR 1.055-1.111)、非体外循环冠状动脉搭桥(OR 1.561)、应用主动脉内球囊泵(OR 2.890-2.966)与房颤独立相关。非体外循环冠状动脉搭桥患者术前hs-cTnT与房颤相关(OR 1.997-2.375)。然而，本组术前hs-cTnT曲线下面积为0.625。结论:术前hs-cTnT水平与行非体外循环冠状动脉搭桥术的孤立性冠脉搭桥术患者发生房颤的风险相关，但该生物标志物的准确性尚不充分。考虑到手术技术和心脏手术本身的影响，术后hs-cTnT水平没有预测价值。因此，围手术期hs-cTnT并不是预测冠脉搭桥后房颤的临床有用的生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Critical Pathways in Cardiology Medicine-Medicine (all)

CiteScore

1.90

自引率

0.00%

发文量

期刊介绍： Critical Pathways in Cardiology provides a single source for the diagnostic and therapeutic protocols in use at hospitals worldwide for patients with cardiac disorders. The Journal presents critical pathways for specific diagnoses—complete with evidence-based rationales—and also publishes studies of these protocols" effectiveness.