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Influence of acute kidney injury on high sensitive troponin after cardiac surgery. a single center retrospective observational study
© Omar et al.; 2015
- Published: 1 October 2015
- Atrial Fibrillation
- Creatine Kinase
- Acute Kidney Injury
- Myocardial Injury
- Cardiac Troponin
The risk assessment of cardiac troponin and other cardiac biomarkers in end-stage renal disease is not equivalent where clinical decision making in patients with renal diseases based on cardiac biomarkers needs justification in relation to patient management or outcomes . Long-term outcome could be influenced by acute kidney injury (AKI) in cardiac surgery , but cardiac troponins need exploration in theses settings.
Assess the diagnostic performance of high sensitive troponin T (hsTnT) in the settings of cardiac surgery-induced AKI. Link it with mortality as well as the lengths of ventilation, ICU stay and hospital stay.
Single center observational retrospective study. A database was available for all patients (sex, age, body mass index, duration of the operation, duration of ICU and hospital length of stay, levels of cardiac enzymes, evidence of perioperative myocardial infarction, early mortality. The lengths of ventilation, stay in ICU, and hospitalization. Based on the Acute Kidney Injury Network, AKI was defined as an abrupt (within 48 h) reduction in kidney function, defined as an absolute increase in serum creatinine concentration of 0.3 mg/dL (26.4 µmol/L) or greater or a percentage increase of 50% or greater (1.5-fold from baseline). Patients divided into 2 groups, group I without AKI (259 patients) and group II with AKI (100 patients) where serial of hsTnT and creatine kinase (CK)-MB followed. Both groups compared and statistically analyzed. We enrolled 359 patients, patients with ESRD were excluded.
Comparison between both groups.
Group I (No AKI) 259 (%)
Group II (AKI) 100 (%)
54.43 ± 10.8
56.09 ± 10.7
3.8 ± 2.4
5.1 ± 3.6
364.1 ± 112
575.5 ± 199
52.9 ± 41.1
109.4 ± 89
10.8 ± 6.4
15.8 ± 7.3
POAF: post operative atrial fibrillation, LOSICU length of stay in ICU, LOV length of ventilation, LOH hospital length of stay
Unlike the CK-MB profile, the hsTnT showed significant changes between both groups all over the course denoting possible delayed clearance in patients with AKI that needs to put in consideration in interpreting post-operative myocardial injury and infarction in this population.
All members of CT department and medical research center, HMC, Doha, Qatar
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