Assessment of myocardial injury by Troponin T in off-pump and conventional coronary artery graft surgery.
Bennetts JS, Baker RA, Ross IK, Knight JL.
ANZ J Surg. 2002;72(2):105-109. doi:10.1046/j.1445-2197.2002.02317.x
Abstract
Purpose: The present study was undertaken to assess the degree of myocardial injury, using troponin T (TnT), in off-pump coronary artery surgery (OPCAB) and in a comparable patient group undergoing conventional coronary artery graft surgery (CABG).
Results: The OPCAB group had significantly greater Canadian Heart Classification 3 patients (P = 0.003); however, other demographic data were similar between the two groups. All patients had normal TnT at initial sampling. The mean number of grafts in each group was 1.8 +/- 0.6 for OPCAB and 1.9 +/- 0.3 for CABG (P = NS). There were two new Q wave myocardial infarctions in the CABG group and none in the OPCAB group. These cases were excluded from biochemical analyses. Troponin T release was significantly less in the OPCAB group at 12 and 24 h (P < 0.001 and P = 0.03, respectively). Peak TnT release occurred at 6-8 h in both groups. Troponin T release was significantly lower in the OPCAB group at 2, 4, 6, 8, 10 and 12 h (P = 0.01, P = 0.03, P = 0.02, P = 0.02, P = 0.03 and P = 0.04, respectively). Postoperatively, the OPCAB group required less blood transfusion (P = 0.02).
Conclusions: The OPCAB group demonstrated a significantly reduced TnT release profile compared with the CABG group.