Clinical InvestigationSurgeryTroponin T is a better predictor than creatine kinase-MB of long-term mortality after coronary artery bypass graft surgery
Section snippets
Patients
One thousand three hundred fifty patients operated on consecutively for isolated CABG, in the time period from January 1, 2003, to December 31, 2006, at Oslo University Hospital, Ullevaal, were included in the study. Patients undergoing additional surgery to CABG were excluded. Data, registered prospectively, were obtained from the hospital database and from patient files. The study was approved by an institutional review board. Few data were missing, and these were coded as absent.
All-cause
Patient characteristics
A total of 1,342 patients were available for analysis, and of these, 1314 patients (97.9%) had complete cTnT and CK-MB values for all 3 postoperative time points, and 28 patients (2.1%) had values for 2 postoperative time points. The mean age ± SD for the cohort was 64.9 ± 10.0 years, and there were 1,089 men (81.1%). The all-cause mortality at 30 days was 0.67%. Totally, 207 patients (15.4%) died during a follow-up period of a median (interquartile range) of 6.1 (5.1-7.2) years. Patients who
Discussion
The present study evaluated the long-term prognostic significance of myocardial damage defined by CK-MB and cTnT release after CABG. We found that both CK-MB and cTnT were predictors of long-term all-cause mortality after CABG in our patient population. However, when analyzing the 2 cardiac markers in the same Cox model, cTnT was a highly significant predictor of mortality, whereas CK-MB was nonsignificant. Troponin T remained a highly significant independent predictor of mortality after
Conclusions
In conclusion, both CK-MB and cTnT are predictors of mortality after CABG surgery; however, our data suggest that cTnT is a better predictor of long-term mortality after CABG surgery than CK-MB. Further studies are warranted to identify the best follow-up regime for patients with postoperatively elevated cTnT.
Disclosures
None.
Acknowledgements
The authors are grateful for the help provided by Dr Stein Koldsland, Heidi Thorstensen, and the staff at the Department of Cardiothoracic Surgery, Oslo University Hospital, Ullevaal.
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