We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Cardiac troponin release following hybrid coronary revascularization versus off-pump coronary artery bypass surgery.
- Authors
Harskamp, Ralf E.; Abdelsalam, Murad; Lopes, Renato D.; Boga, Gouthami; Hirji, Sameer; Krishnan, Mrinalini; Kiljanek, Lukasz; Mumtaz, Mubashir; Tijssen, Jan G.; McCarty, Christine; de Winter, Robbert J.; Bachinsky, William B.
- Abstract
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.
- Publication
Interactive Cardiovascular & Thoracic Surgery, 2014, Vol 19, Issue 6, p1008
- ISSN
1569-9293
- Publication type
Article
- DOI
10.1093/icvts/ivu297