Evidence map›Paper›PMID 27397448›Full record

ArticleAnnals of cardiac anaesthesia

Short-term prognostic value of perioperative coronary sinus-derived-serum cardiac troponin-I, creatine kinase-MB, lactate, pyruvate, and lactate-pyruvate ratio in adult patients undergoing open heart surgery.

Ujjwal Kumar Chowdhury, Avneesh Sheil, Poonam Malhotra Kapoor, Rajiv Narang, Parag Gharde, Vishwas Malik, Mani Kalaivani, Arindam Chaudhury

Abstract read
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Article in Annals of cardiac anaesthesia. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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4citing papers in PubMed
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3 · Its place in the literature

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4 citing papers in PubMed.

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5 · Who and what money

Authors and funding

8 authors.

Ujjwal Kumar ChowdhuryDepartment of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.
Avneesh SheilDepartment of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Poonam Malhotra KapoorDepartment of Cardiovascular Anaesthesia, All India Institute of Medical Sciences, New Delhi, India.
Rajiv NarangDepartment of Cardiology, CNC, All India Institute of Medical Sciences, New Delhi, India.
Parag GhardeDepartment of Cardiovascular Anaesthesia, All India Institute of Medical Sciences, New Delhi, India.
Vishwas MalikDepartment of Cardiovascular Anaesthesia, All India Institute of Medical Sciences, New Delhi, India.
Mani KalaivaniDepartment of Baiostatistics, All India Institute of Medical Sciences, New Delhi, India.
Arindam ChaudhuryDepartment of Cardiovascular Anaesthesia, All India Institute of Medical Sciences, New Delhi, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo investigate the release pattern of different cardiac metabolites and biomarkers directly from the coronary sinus (CS) and to establish the diagnostic discrimination limits of each marker protein and metabolites to evaluate perioperative myocardial injury in patients undergoing cardiac surgery under cardiopulmonary bypass (CPB). PATIENTS AND

methodsSixty-eight patients undergoing first mitral and/or aortic valve replacements with/without coronary artery bypass grafting and Bentall procedure under CPB and blood cardioplegic arrest were studied. All cardiac metabolites and biomarkers were measured in serial CS-derived blood samples at pre-CPB, immediate post aortic declamping, 10 minutes post-CPB and 12 hrs post-CPB.

resultsReceiver operating characteristic curve analysis of cardiac biomarkers indicated lactate-pyruvate ratio as the superior diagnostic discriminator of myocardial injury with an optimal "cut-off" value >10.8 immediately after aortic declamping (AUC, 0.92; 95% CI: 0.85-0.98). Lactate was the second best diagnostic discriminator of myocardial injury with an optimal "cut-off" value >2mmol/l at immediately after aortic declamping (AUC, 0.89; 95% CI: 0.80-0.96). Cardiac troponin-I was the third best diagnostic discriminator of myocardial injury with an optimal "cut-off" value >2.1ng/ml at immediately after aortic declamping (AUC, 0.88; 95% CI: 0.80-0.95). Creatine kinase-MB was the fourth best diagnostic discriminator of myocardial injury with an optimal "cut-off" value >58 log units/ml prior to decanulation (AUC, 0.85; 95% CI: 0.78-0.94).

conclusionsMeasurable cardiac damage exists in all patients undergoing cardiac surgery under cardioplegic arrest. The degree of myocardial injury is more in patients with poor ventricular function and those requiring longer aortic clamp time. CS-derived lactate-pyruvate ratio, lactate, cTn-I served as superior diagnostic discriminators of peri-operative myocardial damage.

Indexed as

Cardiopulmonary BypassPerioperative PeriodAdolescentAdultAgedBiomarkersCoronary SinusCreatine Kinase, MB FormFemaleHumansLactic AcidMaleMiddle AgedPrognosisProspective StudiesPyruvic AcidBiomarkersCreatine Kinase, MB FormLactic AcidPyruvic AcidTroponin I

Identifiers

PMID27397448
PMCPMC4971972

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.