TY - JOUR
T1 - Cardiac troponin release following hybrid coronary revascularization versus off-pump coronary artery bypass surgery
AU - Harskamp, Ralf E.
AU - Abdelsalam, Murad
AU - Lopes, Renato D.
AU - Boga, Gouthami
AU - Hirji, Sameer
AU - Krishnan, Mrinalini
AU - Kiljanek, Lukasz
AU - Mumtaz, Mubashir
AU - Tijssen, Jan G.
AU - McCarty, Christine
AU - de Winter, Robbert J.
AU - Bachinsky, William B.
PY - 2014
Y1 - 2014
N2 - 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). 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. 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). HCR is associated with lower postoperative cTn release, compared with OPCAB. Further research into the clinical implications of this finding is warranted
AB - 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). 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. 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). HCR is associated with lower postoperative cTn release, compared with OPCAB. Further research into the clinical implications of this finding is warranted
U2 - https://doi.org/10.1093/icvts/ivu297
DO - https://doi.org/10.1093/icvts/ivu297
M3 - Article
C2 - 25217621
SN - 1569-9293
VL - 19
SP - 1008
EP - 1012
JO - Interactive cardiovascular and thoracic surgery
JF - Interactive cardiovascular and thoracic surgery
IS - 6
ER -