Perioperative factors associated with changes in troponin T during coronary artery bypass grafting

Abstract Objective Investigate important clinical and operative variables associated with increases in cardiac troponin T (cTnT) as indicators of myocardial injury following coronary artery bypass grafting (CABG). Design Prospective cohort study. Setting Single university hospital. Participants 626 patients undergoing isolated CABG April 2008-April 2010. Validation cohort (n=686) from 2015-2017. Interventions None. Measurements and main results Perioperative variables were prospectively registered. The extent of diffuse coronary atherosclerosis and significant stenoses were assessed by preoperative coronary angiography. Mixed model analysis was used to construct a statistical model explaining the course of cTnT concentrations. The model was adjusted for pre- and intra-/postoperative myocardial infarction (MI) for independent assessment of additional variables. Clinical factors associated with increased cTnT concentrations during and after CABG were longer duration of cardiopulmonary bypass (CPB, p Conclusions LVEF, NYHA classification, kidney function, inflammation status, duration of CPB, BSA and preoperative MI were associated with the cTnT rise-and-fall pattern related to myocardial injury following CABG. Information regarding these variables may be valuable when utilising cTnT in diagnostic work-up of postoperative MI.