RT info:eu-repo/semantics/article
T1 Diagnosis of perioperative myocardial infarction after heart valve surgery with new cut-off point of high-sensitivity troponin T and new electrocardiogram or echocardiogram changes
A1 Cubero Gallego, Héctor
A1 Lorenzo López, Mario
A1 Heredia Rodríguez, María
A1 Gómez Salvador, Itziar
A1 Tamayo Gómez, Eduardo
K1 Perioperative myocardial infarction
K1 Infarto miocárdico perioperatorio
K1 Heart valves
K1 Válvulas cardíacas
K1 Troponin
K1 Troponina
K1 Cardiograms
K1 Cardiogramas
K1 3213.07 Cirugía del Corazón
AB Objective: Criteria for diagnosing myocardial infarction (MI) after heart valve surgery are not collected in the Third Universal Definition of MI. We aimed to define cut-offs for high-sensitivity cardiac troponin T (hs-cTnT) and creatine kinase-MB (CK-MB) for the diagnosis of perioperative MI after heart valve surgery according to perioperative MI determined by new alterations in electrocardiogram (ECG) and/or transthoracic echocardiogram (TTE). Secondary endpoints were incidence of perioperative MI, postoperative complications, 30-day mortality, and 2-year survival. Methods: Heart valve surgery was performed in 805 patients (June 2012-January 2016). hs-cTnT and CK-MB were measured at intensive care unit (ICU) admission and 8, 16, 24, 48, and 72 hours after surgery. Blind to outcomes, we analyzed ECGs and TTEs before and after surgery. Patients were divided into 2 groups: with ECG and/or TTE criteria after surgery (following the consensus statement) and without these changes. We conducted receiver operating characteristic analyses for hs-cTnT and CK-MB in the group with ECG and/or TTE criteria. Results: ECG and/or TTE criteria were observed in 88 patients. Receiver operating characteristic analyses in this group showed hs-cTnT levels of 732.3 pg/mL at ICU admission; 1008 pg/mL at 8 hours, 1057 pg/mL at 16 hours, and 958.3 pg/mL at 24 hours after surgery ( P < .001) and CK-MB levels of 26.78 mg/dL at ICU admission, 54.88 mg/dL at 8 hours, 38.98 mg/dL at 16 hours, and 18.4 mg/dL at 24 hours after surgery ( P < .001). Conclusions: Cut-offs for hs-cTnT and CK-MB to diagnose perioperative MI after heart valve surgery are well above upper reference limit. These findings update the Third Universal Definition providing cut-offs to diagnose perioperative MI after heart valve surgery.
PB Elsevier
SN 0022-5223
YR 2017
FD 2017
LK http://uvadoc.uva.es/handle/10324/45647
UL http://uvadoc.uva.es/handle/10324/45647
LA eng
NO The Journal of Thoracic and Cardiovascular Surgery, 2017, vol. 154, n. 3. p. 895-903
NO Producción Científica
DS UVaDOC
RD 23-nov-2024