Correlation between high-sensitivity cardiac troponin I, lactate levels, and clinical outcomes in on-pump coronary artery bypass grafting

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Published: Sep 15, 2023
Keywords:
High-sensitivity cardiac troponin I, lactate, clinical outcomes, on-pump coronary artery bypass grafting

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Phatiwat Chotimol
Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok Province, Thailand.
Jarun Sayasathid
Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine, Naresuan University Hospital, Naresuan University, Phitsanulok Province, Thailand.
Kanthachat Thatsakorn
Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine, Naresuan University Hospital, Naresuan University, Phitsanulok Province, Thailand.
Siraphop Thapmongkol
Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine, Naresuan University Hospital, Naresuan University, Phitsanulok Province, Thailand.
Kittisak Thawnashom
Department of Medical Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok Province, Thailand.

Abstract

Background: On-pump coronary artery bypass graft (CABG) causes myocardial damage and hypoperfusion. However, it is unknown how varied timings of combining serum high-sensitivity cardiac troponin I (hs-cTnI) and lactate levels in on-pump CABG surgery would affect clinical outcomes.


Objectives: This study aims to evaluate serum hs-cTnI and lactate levels and their influence on postoperative clinical outcomes in patients with on-pump CABG.


Materials and methods: Eleven coronary artery disease (CAD) patients were included for on-pump CABG surgery. The biomarkers were collected at four stages of onpump CABG: before sternotomy (T0, pre-cardiopulmonary bypass (pre-CPB)), 5 minutes before aortic cross-clamp of CPB (T1, preaortic cross-clamp), after aortic cross-clamp (T2, postaortic cross-clamp), and 24 hrs post-surgery in an intensive care unit (T3, ICU at 24 hrs).


Results: Correlation analysis revealed that during the study period, average hs-cTnI is positively associated with lactate levels (r=0.775, p=0.005). However, 24 hours after surgery, lactate levels return more quickly than hs-cTnI levels. The average hs-cTnI and lactate levels were positively correlated with CPB time and aortic clamp time. Regarding clinical outcomes, average hs-cTnI, and lactate levels were positively associated with a length of ICU stay (r=0.717 and 0.612, p=0.013 and 0.045, respectively). However, only the lactate levels were associated with ventilator support time (r=0.674, p=0.023).


Conclusion: We demonstrated that hs-cTnI and lactate levels are important markers of myocardial injury in association with hypoperfusion during on-pump CABG, and it could be used to monitor the postoperative outcome.

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How to Cite
Chotimol, P., Sayasathid, J., Thatsakorn, K., Thapmongkol, S., & Thawnashom, K. (2023). Correlation between high-sensitivity cardiac troponin I, lactate levels, and clinical outcomes in on-pump coronary artery bypass grafting. Journal of Associated Medical Sciences, 57(1), 1–9. Retrieved from https://he01.tci-thaijo.org/index.php/bulletinAMS/article/view/262764
Issue
Vol. 57 No. 1 (2024): January-Aprill
Section
Research Articles
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