Cardiac troponin release following hybrid coronary revascularization versus off-pump coronary artery bypass surgery.

Published

Journal Article

OBJECTIVES: Cardiac ischaemic marker release is associated with adverse clinical outcomes after cardiac surgery. We sought to compare the release of cardiac troponin I (cTnI) after hybrid coronary revascularization (HCR) with off-pump coronary artery bypass surgery (OPCAB). METHODS: Using data from a prospective single-centre registry, we compared cTnI measured at postoperative day 1 following one-stage HCR and OPCAB among patients with normal baseline cTnI. Multivariable linear regression analysis was used to adjust for variables that may have influenced cardiac marker release other than the used revascularization strategy. RESULTS: Sixty-five consecutive patients underwent elective HCR (n = 33) or OPCAB (n = 32). Overall, no differences were seen in comorbidities, CABG risk scores and the lesion-specific SYNTAX score. Procedural complications were lower (15.2 vs 34.4%, P = 0.072), but 30-day and 1-year clinical outcomes (death, myocardial infarction, and repeat revascularization) were similar between the two groups (3.0 vs 3.1% and 9.1 vs 6.2%, respectively). Post-procedural cTnI release measured at 24 h after surgery was significantly lower following HCR compared with OPCAB [ratio of upper reference level URL: median: 3.5, interquartile range (IQR): 0.8-9.1 vs 12.8, IQR: 6.9-21.8, P = 0.001]. After adjusting for potential confounders, HCR was associated, on average, with cTnI less than half (46%) compared with CABG (P <0.0001). CONCLUSIONS: HCR is associated with lower postoperative cTn release, compared with OPCAB. Further research into the clinical implications of this finding is warranted.

Full Text

Duke Authors

Cited Authors

  • Harskamp, RE; Abdelsalam, M; Lopes, RD; Boga, G; Hirji, S; Krishnan, M; Kiljanek, L; Mumtaz, M; Tijssen, JG; McCarty, C; de Winter, RJ; Bachinsky, WB

Published Date

  • December 2014

Published In

Volume / Issue

  • 19 / 6

Start / End Page

  • 1008 - 1012

PubMed ID

  • 25217621

Pubmed Central ID

  • 25217621

Electronic International Standard Serial Number (EISSN)

  • 1569-9285

Digital Object Identifier (DOI)

  • 10.1093/icvts/ivu297

Language

  • eng

Conference Location

  • England