Perioperative Cardiac Troponin T and Risk of Postoperative Atrial Fibrillation in Coronary Artery Bypass Graft Surgery. Issue 1 (March 2022)

• Record Type: Journal Article
• Authors: Farahani, Ali Vasheghani; Omran, Abbas Salehi; Abbasi, Kyomars; Gholamrezaei, Ali; Mansouri, Pejman; Tafti, Seyed Hossein Ahmadi; Jahangiri, Mansour
• Is Part Of: Critical pathways in cardiology. Volume 21:Issue 1(2022)
• Publication Date: 2022-03
• Subjects: atrial fibrillation -- arrhythmias -- coronary artery bypass -- risk assessment -- troponin T; Cardiology -- Periodicals; Evidence-based medicine -- Periodicals; Medical protocols -- Periodicals; 616.12005
• DOI: 10.1097/HPC.0000000000000276
• Languages: English
• ISSNs: 1535-282X

Abstract

Abstract : Background: Postoperative atrial fibrillation (AF) is a common complication after cardiac surgery. We investigated whether perioperative cardiac troponin T (cTnT) is associated with the risk of AF after coronary artery bypass grafting (CABG). Methods: Two thousand four hundred twenty-one patients with isolated CABG were studied. High sensitivity cTnT (hs-cTnT) was assessed before and then at 80 hour and 24 hour after the operation. Logistic regression models were applied to investigate the association of perioperative hs-cTnT with postoperative AF. The ROC curve analysis was applied to determine the optimal cutoff values. Results: Postoperative AF was occurred in 356 (14.7%) patients. Age (adjusted odds ratio [ORs] 1.087–1.090), male gender (OR 1.390), left atrium size (ORs 1.055–1.111), on-pump coronary bypass (OR 1.561), and application of intra-aortic balloon pump (ORs 2.890–2.966) were independently associated with AF. Preoperative hs-cTnT was associated with AF in patients with off-pump coronary bypass (ORs 1.997–2.375). However, the area under the curve for preoperative hs-cTnT was 0.625 in this group. On-pump coronary bypass had major influence on postoperative hs-cTnT levels regardless of the occurrence of AF. Conclusions: Preoperative hs-cTnT level is associated with the risk of AF after isolated CABG in patients undergoing off-pump coronary bypass, but the accuracy of this biomarker is yet inadequate. Postoperative levels of hs-cTnT have no predictive value considering large influence by the surgical technique and the cardiac surgery itself. Therefore, perioperative hs-cTnT is not a clinically useful biomarker for predicting AF following CABG.