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Cardiothoracic and Vascular Anesthesia
Anesthesia and Pain Medicine 2009;4(2):124-128.
Published online April 30, 2009.
The relationship of serum creatinine and cardiac troponin I after off-pump coronary artery bypass graft surgery
Hwa Sung Jung, Che Sun Kim, Tae Yop Kim
1Department of Anesthesiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea. pondkim@unitel.co.kr
2Department of Anesthesiology, GangNeung Asan Hospital, School of Medicine, University of Ulsan, Gangneung, Korea.
3Department of Anesthesiology and Pain Medicine, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea.
Abstract
BACKGROUND
Renal dysfunction is an independent risk factor of cardiac dysfunction and one of common complications after cardiac surgery. This study was designed to evaluate the relationship between serum creatinine (s-Cr) and cardiac troponin I (cTnI) in off-pump coronary artery bypass graft surgery (OPCAB).
METHODS
Data, from 13 patients underwent OPCAB, were analyzed in prospective fashion. The levels of s-Cr and cTnI were evaluated before and after OPCAB. The correlations of s-Cr and TnI were analyzed in the patients with cardiac dysfunction assessed by low cardiac output or stroke volume at end of surgery.
RESULTS
Patients with preoperatively elevated s-Cr (female, > or =1.2 microg/L; male, > or =1.5microg/L) showed higher incidence of elevated s-Cr and elevated cTnI (> or =0.68microg/L) on arrival at intensive care unit (POD-0), postoperative 12 hours (POD-1) and postoperative 36 hours (POD-2) (P< 0.05). Patients with preoperatively elevated cTnI showed higher incidence of elevated cTnI at POD-0, POD-1 and POD-2 (P< 0.05). In 7 patients with low cardiac index (< 2.0 L/min/m2) or stroke volume index (<40 mL/beat/m2) at end of surgery, the increases of s-Cr and cTnI showed positive correlation at POD-0, POD-1 and POD-2 (correlation coefficient 0.818, 0.864 and 0.785, respectively).
CONCLUSIONS
The increases of s-Cr and cTnI showed positive correlation in low cardiac output after OPCAB. The results suggested that elevated s-Cr may be an independent predictor of elevated cTnI representing perioperative myocardial injury.
Key Words: creatinine, off-pump coronary artery bypass grafting surgery, troponin I


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