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Título
Influence of impairment in renal function on the accuracy of high-sensitivity cardiac troponin T for the diagnosis of perioperative myocardial infarction after heart valve surgery
Año del Documento
2018
Editorial
Oxford University Press
Descripción
Producción Científica
Documento Fuente
Interactive CardioVascular and Thoracic Surgery, 2018, vol. 27, n. 2. p. 234–237
Resumen
We aimed to assess the influence of impairment in renal function over the high-sensitivity cardiac troponin T (hs-cTnT) accuracy to diagnose perioperative myocardial infarction (MI) after heart valve surgery. Heart valve surgery was performed in 805 patients from June 2012 to January 2016. Patients with enzymatic curves of hs-cTnT suggestive of myocardial necrosis and electrocardiogram and/or transthoracic echocardiogram criteria were identified as patients with perioperative MI. Impairment in renal function was defined as a postoperative creatinine clearance <50 ml/min at 16 h after surgery and for at least 48 h. Patients included were divided into 2 groups at 16 h: (i) patients with normal renal function (creatinine clearance >50 ml/min) and (ii) patients with impairment in renal function (creatinine clearance <50 ml/min). From a total of 805 patients undergoing heart valve surgery, 88 patients developed perioperative MI. When comparing receiver operating characteristic curves in patients with perioperative MI according to renal function, the optimal threshold of hs-cTnT at 16 h differed in patients with impairment in renal function (1303 vs 1095 pg/ml, P < 0.001). The diagnostic accuracy of hs-cTnT at 16 h was 93.4% [95% confidence interval (CI) 89.98–96.86], with an area under receiver operating characteristic curve (0.993, 95% CI 0.988–0.999 vs 0.972, 95% CI 0.952–0.992; P < 0.001). Renal function might influence in hs-cTnT levels. However, a hs-cTnT threshold of 1303 pg/ml at 16 h may be applied according to renal function to diagnose perioperative MI after cardiac surgery.
Materias Unesco
3213.07 Cirugía del Corazón
Palabras Clave
Cardiac troponin T
Troponina T cardiaca
Renal dysfunction
Disfunción renal
Myocardial infarction
Infarto de miocardio
ISSN
1569-9285
Revisión por pares
SI
Version del Editor
Propietario de los Derechos
© 2018 Oxford University Press
Idioma
eng
Tipo de versión
info:eu-repo/semantics/publishedVersion
Derechos
openAccess
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