ArticleClinical cardiology2009
Value of early cardiac troponin I to predict long-term adverse events after coronary artery bypass graft surgery in patients presenting with acute coronary syndromes.
Article in Clinical cardiology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- N-Acetylcysteine for Cardiac Protection During Coronary Artery Reperfusion: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Frontiers in cardiovascular medicine · 2021Pooled it
- Improving the prediction of long-term readmission and mortality using a novel biomarker panel.Journal of cardiac surgery · 2021Article
- Timing of coronary artery bypass surgery in patients with non-ST-segment elevation myocardial infarction and postoperative outcomes.Archives of medical science : AMS · 2016Article
- Emergency Cardiac Biomarkers and Point-of-Care Testing: Optimizing Acute Coronary Syndrome Care Using Small-World Networks In Rural Settings.Point of care · 2010Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh values of both preoperative and postoperative cardiac troponin I (cTnI) contribute to higher rates of short-term cardiac events following coronary artery bypass graft (CABG) surgery in patients with acute coronary syndrome (ACS). The prognostic value of very early cTnI in this context is unclear. HYPOTHESIS: Measurement of cTnI very early after admission to the emergency room can be used as a prognosticator for long-term outcomes after CABG.
methodsWe conducted a cohort study on 160 consecutive patients with ACS undergoing CABG at The John H. Stroger Jr. Hospital of Cook County (Chicago, IL) representing a total follow-up of 290.42 person-years. Adverse outcomes were defined as death or reinfarction. We used robust multivariate survival analyses to determine whether early cTnI measurement can independently predict the adverse outcomes in the study subjects.
resultsIn univariate and stepwise multivariate Cox proportional hazards modeling we found that unit rise in early cTnI is associated with a 3% (95% confidence interval [CI]: 2%- 5%, p < 0.001) faster progression to long-term adverse events after CABG even after adjusting for the type of ACS. Prognostically, the most informative cut off value for cTnI was 5.6 ng/mL. Above this value, CABG patients progressed 2.58 times faster to adverse outcomes (95% CI: 1.05-6.36, p = 0.039). This effect remained after adjustment for other significant confounders namely, poor compliance to medications, female sex, Medicaid insurance, and electrocardiographic ischemia.
conclusionEarly cTnI measurement after admission can predict adverse outcomes after CABG. This association extends to long-term adverse events after CABG.
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