Short-term outcome of patients with elevated serum cardiac troponin I following off-pump coronary artery bypass grafting

Authors

  • Pranab Bhattacharjee Department of Cardiovascular Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Istiaq Ahmed Department of Cardiovascular Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • A. S. M. Hossain Kabir Department of Cardiac Surgery, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh
  • Tonusree Chakrabarty Department of Blood Transfusion, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Amit Sen Gupta Department of Surgery, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh
  • M. Sumaia Bin-te Shawkat Department of Surgery, Shahid M. Monsur Ali Medical College, Sirajgonj, Bangladesh
  • Susmita Saha Resident Medical Officer, Asgar Ali Hospital, Dhaka, Bangladesh
  • Mashfiq Anwar Clinical Attache, Glangwili General Hospital, Wales, United Kingdom

DOI:

https://doi.org/10.18203/2320-6012.ijrms20242917

Keywords:

CAD, CABG, OPCAB, Short-term outcome, Troponin I

Abstract

Background: Coronary artery disease (CAD) is a global issue at present. It is one of the leading causes of death and disability in men and women in the USA, Western Europe and many other countries. Coronary artery bypass grafting (CABG) is the gold standard for revascularization in coronary artery disease. This study aimed to observe the short-term outcome of patients with elevated serum cardiac troponin I (cTnI) following off-pump coronary artery bypass grafting.

Methods: This was a prospective observational study and was carried out at the Department of Cardiac Surgery of the National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh during the period from July 2020 to October 2021. In this study, we included 80 patients admitted for elective CABG at National Heart Foundation Hospital and Research Institute.

Results: Among all patients, 11.3% patients had acute MI, followed by respiratory complication (11.3%), arrythmia (10%), wound infection (6.3%), neurological complication (5%), renal complication (1.3%) and only 2.5% patients died. The mean±SD troponin I in 1st, 2nd and 3rd post operative days of the patients was 10.80±13.39, 7.99±10.39 and 4.73±6.98 respectively. The area under the recipient operational characteristic (ROC) curve was 0.931 with 95% CI were between 0.863 and 0.999, which was statistically highly significant (<0.001). There is no significant association of cTnI with respiratory, renal, neurological complications and wound infection.

Conclusions: Our findings showed that there was a significant association between raised cTnI concentrations after OPCAB surgery and adverse events in the early postoperative period.

References

Moran AE, Oliver JT, Mirzaie M, Forouzanfar MH, Chilov M, Anderson L, et al. Assessing the global burden of ischemic heart disease: part 1: methods for a systematic review of the global epidemiology of ischemic heart disease in 1990 and 2010. Global heart. 2012;7(4):315-29.

Ahmad T, Alam MB, Khan A, Islam AM, Hossain Z, Asaduzzaman K. Study on risk factors and pattern of coronary artery involvement in young acute coronary syndrome patients. Bangl Heart J. 2017;32(1):40-4.

Banerjeel SK, Ahmed CM, Rhaman MM, Chowdhury MM, Sayeed MA. Coronary artery disease in a rural population of Bangladesh: is dyslipidemia or adiposity a significant risk?. J Med Sci. 2017;11(2):61-9.

Islam AM, Majumder AA. Coronary artery disease in Bangladesh: A review. Ind Heart J. 2013;65(4):424-35.

Russell EM. Coronary artery bypass grafting. Brit Med J (Clinical research ed.). 1985;290(6462):154.

Agarwal GR, Krishna N, Raveendran G, Jose R, Padmanabhan M, Jayant A, et al. Early outcomes in patients undergoing off-pump coronary artery bypass grafting. Ind J Thora Cardiovasc Surg. 2019;35(2):168-74.

Matsuura K, Kobayashi J, Tagusari O, Bando K, Niwaya K, Nakajima H, et al. Rationale for off-pump coronary revascularization to small branches-angiographic study of 1,283 anastomoses in 408 patients. Ann Thor Surg. 2004;77(5):1530-4.

Pretto P, Martins GF, Biscaro A, Kruczan DD, Jessen B. Perioperative myocardial infarction in patients undergoing coronary artery bypass grafting. Brazil J Cardiova Surg. 2015;30(1):49-54.

Croal BL, Hillis GS, Gibson PH, Fazal MT, El-Shafei H, Gibson G, et al. Relationship between postoperative cardiac troponin I levels and outcome of cardiac surgery. Circulat. 2006;114(14):1468-75.

de Castro Martínez J, MI IM. Cardiac troponin I in perioperative myocardial infarction after coronary artery bypass surgery. Revis Espan Cardiol. 2002;55(3):245-50.

Leal JC, Petrucci O, Godoy MF, Braile DM. Perioperative serum troponin I levels are associated with higher risk for atrial fibrillation in patients undergoing coronary artery bypass graft surgery. Interact Cardiovas Thora Surg. 2012;14(1):22-5.

Mostafa AM, Ammar S, Abdou M, Abd El Shafy M. Incidence of perioperative myocardial infarction following coronary artery bypass grafting (CABG). Am J Res Communicat. 2016;4(2):38-48.

Force T, Hibberd P, Weeks G, Kemper AJ, Bloomfield P, Tow D, et al. Perioperative myocardial infarction after coronary artery bypass surgery. Clinical significance and approach to risk stratification. Circulat. 1990;82(3):903-12.

Légaré JF, Hirsch G, Verma S. Off-pump coronary artery bypass graft surgery is standard of care: Where do you stand?. Canad J Cardio. 2006;22(13):1107-10.

Khalifa YS, Eisa KM, Bary MA, Ismail HE, Taha AM. Short term outcome of coronary artery bypass graft surgery: Evaluation of recently established cardiac center. J Egyp Soc Cardio-Thor Surg. 2018;26(1):24-9.

Sadony V, Körber M, Albes G, Podtschaske V, Etgen T, Trösken T, et al. Cardiac troponin I plasma levels for diagnosis and quantitation of perioperative myocardial damage in patients undergoing coronary artery bypass surgery. Euro J Cardio-Thoracic Surg. 1998;13(1):57-65.

Li Y, Li Y, Hu Q, Zheng S, Tian B, Meng F, et al. 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. J Thor Dis. 2020;12(11):6542.

Paparella D, Cappabianca G, Malvindi P, Paramythiotis A, Galeone A, Veneziani N, et al. Myocardial injury after off-pump coronary artery bypass grafting operation. Euro J Cardio-Thor Surg. 2007;32(3):481-7.

Patra C, Gatti PC, Panigrahi A. Morbidity After cardiac surgery under cardiopulmonary bypass and associated factors: A retrospective observational study. Ind Heart J. 2019;71(4):350-5.

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Published

2024-09-30

How to Cite

Bhattacharjee, P., Ahmed, I., Hossain Kabir, A. S. M., Chakrabarty, T., Gupta, A. S., Sumaia Bin-te Shawkat, M., Saha, S., & Anwar, M. (2024). Short-term outcome of patients with elevated serum cardiac troponin I following off-pump coronary artery bypass grafting. International Journal of Research in Medical Sciences, 12(10), 3615–3621. https://doi.org/10.18203/2320-6012.ijrms20242917

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Original Research Articles