Evidence map›Paper›PMID 41689183›Full record

Observational studyInterdisciplinary cardiovascular and thoracic surgery2026

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.

Grace S Lee, Derrick Y Tam, Dominique Vervoort, Shun Fu Lee, Katheryn Brady, Emilie Belley-Cote, P J Devereaux, Andre Lamy, Richard Whitlock, Ryan Louie and 1 more

Abstract readComparative StudyMulticenter StudyObservational Study
In one paragraph

Observational study in Interdisciplinary cardiovascular and thoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Grace S LeeDivision of Cardiac Surgery, University of Toronto, Toronto, ON M5G 2C4, Canada.ORCID 0000-0002-5062-6461
Derrick Y TamDivision of Cardiac Surgery, University of Toronto, Toronto, ON M5G 2C4, Canada.
Dominique VervoortInstitute of Health Policy, Management and Evaluation, Toronto, ON M5T 3M6, Canada.ORCID 0000-0002-3142-0388
Shun Fu LeePopulation Health Research Institute, Hamilton, ON L8L 2X2, Canada.
Katheryn BradyPopulation Health Research Institute, Hamilton, ON L8L 2X2, Canada.
Emilie Belley-CotePopulation Health Research Institute, Hamilton, ON L8L 2X2, Canada.
P J DevereauxHealth Research Methods, Evidence, and Impact, Hamilton, McMaster University, ON L8S 4L8, Canada.
Andre LamyPopulation Health Research Institute, Hamilton, ON L8L 2X2, Canada.ORCID 0000-0003-2777-7621
Richard WhitlockPopulation Health Research Institute, Hamilton, ON L8L 2X2, Canada.
Ryan LouiePopulation Health Research Institute, Hamilton, ON L8L 2X2, Canada.
Stephen E FremesDivision of Cardiac Surgery, University of Toronto, Toronto, ON M5G 2C4, Canada.ORCID 0000-0003-1723-3049

Funding

Abbott LaboratoriesAcademic Health Science Centres Alternative Funding Plan Innovation Fund OntarioBritish Heart Foundation Personal Chair grant CH/F/21/90010Canadian Institute of Health Research (CIHR)Canadian Network and Centre for Trials InternationallyCIHR FoundationCIHR Strategy for Patient Oriented ResearchGeneral Research Fund 14101414Hamilton Health Sciences New Investigator Fund and Research Strategic InitiativeHong Kong Special Administrative RegionInstituto de Salud Carlos III PI13/00502McMaster University Surgical AssociatesNational Health and Medical ResearchNational Heart Foundation of Australia Vanguard 101034Population Health Research Institute (PHRI) Internal FundingResearch Excellence RE/18/5/34216Research Grant CouncilThe VISION Cardiac Surgery StudyUniversity of Malaya research RG302-14AFR
6 · The paper itself

Abstract

objectivesWe aimed to determine whether high-sensitivity cardiac troponin I (hs-cTnI) thresholds associated with increased 30-day mortality isolated coronary artery bypass grafting (CABG) differed between those undergoing off-pump (OPCAB) and on-pump (ONCAB) CABG.

methodsWe conducted a subanalysis of patients who underwent isolated CABG in the Vascular Events in Surgery Patients Cohort Evaluation (VISION) Cardiac Surgery Study. Cox regression was used to determine the hazard ratios (HRs) for mortality based on postoperative day 1 log-transformed hs-cTnI adjusted by EuroSCORE II, with OPCAB versus ONCAB as an interaction term. HRs were modelled as a function of hs-cTnI, and the lowest troponin associated with HR ≥ 1.00 was identified for each group.

resultsOf the original VISION cohort, 6505 patients underwent isolated CABG (OPCAB = 1141, ONCAB = 5364). Median hs-cTnI after CABG was 2446 ng/L (interquartile range [IQR] 1164-5654), and lower after OPCAB (640 ng/L [264-1689]) than ONCAB (2972 ng/L [1536-6448], P < .001). There were no differences in 30-day mortality between OPCAB and ONCAB (1.7% vs 1.4%, P = .5). Increased log-peak hs-cTnI was associated with greater mortality after CABG (adjusted HR = 1.7 [95% CI, 1.4-2.1]). The hs-cTnI threshold associated with HR ≥ 1.00 for isolated CABG was 6549 ng/L (95% CI, 3609-8381). OPCAB versus ONCAB had a significant interaction effect on the association between hs-cTnI and mortality (interaction P = .002). The hs-cTnI threshold associated with mortality after OPCAB was ≥4708 ng/L (95% CI, 581-7177), compared to ≥6806 ng/L (95% CI, 4001-13 993) after ONCAB.

conclusionsThe clinically significant hs-cTnI threshold after CABG associated with an increased risk of 30-day mortality above the baseline is substantially higher than defined by current guidelines, but lower in patients undergoing OPCAB compared to ONCAB.

Indexed as

Coronary Artery BypassCoronary Artery Bypass, Off-PumpCoronary Artery DiseaseTroponin IAgedBiomarkersFemaleHumansMaleMiddle AgedRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeBiomarkersTroponin ICABGmyocardial infarctionoff-pump CABGon-pump CABGtroponin

Identifiers

PMID41689183
PMCPMC12930846

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

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.