ArticleEuropean heart journal2022
High-sensitivity cardiac troponin I after coronary artery bypass grafting for post-operative decision-making.
Article in European heart journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- The prognostic impact of prevailing definitions of periprocedural myocardial infarction in patients undergoing coronary artery bypass grafting.European heart journal. Quality of care & clinical outcomes · 2025Pooled it
- Combined Antegrade-Retrograde Cardioplegia for Myocardial Protection During Coronary Artery Bypass Grafting in Patients with Left Main Coronary Artery Disease: The CARDIOPROTECT-LMCAD Randomised Trial.Medicina (Kaunas, Lithuania) · 2026Trial
- High-Sensitivity Cardiac Troponin I and Mortality Following Off-Pump and On-Pump Coronary Artery Bypass Surgery: A Secondary Analysis of the Vision Cardiac Surgery Study.Interdisciplinary cardiovascular and thoracic surgery · 2026Observational
- Article
- Prognostic value of high-sensitivity cardiac troponin I after isolated non-CABG cardiac surgery.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Article
- Unplanned Postoperative Angiography After Isolated Coronary Artery Bypass Grafting: State of the Art and Future Perspective.Medicina (Kaunas, Lithuania) · 2025Review
- Symptomatic early coronary graft failure in bypass surgery patients: incidence, predictors and clinical impact.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2025Article
- Recent clinical research on the value of high-sensitivity cardiac troponin levels in prognostic evaluation after coronary artery bypass graft surgery: a narrative review.Cardiovascular diagnosis and therapy · 2025Review
- Impact of impaired renal function on kinetics of high-sensitive cardiac troponin following cardiac surgery.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Article
- Single-centre, single-blind, randomized, active-controlled phase-3 non-inferiority study to investigate the safety and efficacy of the cardioplegic solution Cardioplexol™.Frontiers in cardiovascular medicine · 2025Article
- High Troponin I in Patients Following Off-pump Coronary Artery Bypass Grafting.Cardiac failure review · 2025Article
- The Role of Triglyceride/HDL Ratio, Triglyceride-Glucose Index, and Pan-Immune-Inflammation Value in the Differential Diagnosis of Acute Coronary Syndrome and Predicting Mortality.Journal of clinical medicine · 2024Article
- The prognostic impact of unplanned invasive coronary angiography following coronary artery bypass grafting.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2024Article
- Detectable troponin below the 99International journal of cardiology. Heart & vasculature · 2024Article
- Defining Peri-Operative Myocardial Injury during Cardiac Surgery Using High-Sensitivity Troponin T.Journal of clinical medicine · 2023Article
- Cardiac Troponin I in Patients Undergoing Percutaneous and Surgical Myocardial Revascularization: Comparison of Analytical Methods.Diagnostics (Basel, Switzerland) · 2023Article
- Cardiac troponin release following coronary artery bypass grafting: mechanisms and clinical implications.European heart journal · 2023Review
- The effects of volatile anesthetics and propofol in patients undergoing off-pump coronary artery bypass grafting: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2023Review
- Right coronary artery deformation and injury following tricuspid valve surgery.Frontiers in cardiovascular medicine · 2022Article
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Authors and funding
15 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsCurrent troponin cut-offs suggested for the post-operative workup of patients following coronary artery bypass graft (CABG) surgery are based on studies using non-high-sensitive troponin assays or are arbitrarily chosen. We aimed to identify an optimal cut-off and timing for a proprietary high-sensitivity cardiac troponin I (hs-cTnI) assay to facilitate post-operative clinical decision-making. METHODS AND
resultsWe performed a retrospective analysis of all patients undergoing elective isolated CABG at our centre between January 2013 and May 2019. Of 4684 consecutive patients, 161 patients (3.48%) underwent invasive coronary angiography after surgery, of whom 86 patients (53.4%) underwent repeat revascularization. We found an optimal cut-off value for peak hs-cTnI of >13 000 ng/L [>500× the upper reference limit (URL)] to be significantly associated with repeat revascularization within 48 h after surgery, which was internally validated through random repeated sampling with 1000 iterations. The same cut-off also predicted 30-day major adverse cardiovascular events and all-cause mortality after a median follow-up of 3.1 years, which was validated in an external cohort. A decision tree analysis of serial hs-cTnI measurements showed no added benefit of hs-cTnI measurements in patients with electrocardiographic or echocardiographic abnormalities or haemodynamic instability. Likewise, early post-operative hs-cTnI elevations had a low yield for clinical decision-making and only later elevations (at 12-16 h post-operatively) using a threshold of 8000 ng/L (307× URL) were significantly associated with repeat revascularization with an area under the curve of 0.92 (95% confidence interval 0.88-0.95).
conclusionOur data suggest that for hs-cTnI, higher cut-offs than currently recommended should be used in the post-operative management of patients following CABG.
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