Myocardial infarction following aortic surgery: a comparison of cardiac troponin I and creatine kinase ratio
Article first published online: 6 DEC 2002
© 2001 British Journal of Surgery Society Ltd
British Journal of Surgery
Volume 88, Issue 4, pages 609–610, April 2001
How to Cite
Haggart, P. C., Adam, D. J., Ludman, P. F. and Bradbury, A. W. (2001), Myocardial infarction following aortic surgery: a comparison of cardiac troponin I and creatine kinase ratio. Br J Surg, 88: 609–610. doi: 10.1046/j.1365-2168.2001.01757-32.x
- Issue published online: 6 DEC 2002
- Article first published online: 6 DEC 2002
- Cited By
Perioperative myocardial infarction may be underdiagnosed and/or misdiagnosed because World Health Organization criteria are often not met and creatinine kinase/creatinine kinase-muscle band (CK/CK-MB) ratios can be difficult to interpret. Cardiac troponin (cTn) I is the most sensitive and specific marker of myocardial cell necrosis but is not yet widely available. The aim was to compare cTnI and CK/CK-MB ratios in the diagnosis of myocardial infarction following aortic surgery.
This prospective study included 58 patients undergoing elective (27 aneurysm, seven occlusive) or emergency (24 ruptured aneurysms) aortic surgery. cTnI concentration was measured before operation and 6, 24, 48, 72 and 96 h after surgery. CK and CK-MB levels were measured where cTnI was detectable. Clinical and electrocardiographically detected cardiac events were documented prospectively.
|Emergency (n = 24)||Elective (n = 34)|
|cTnI rise > 0·5 ng ml−1||13||9|
|CK/CK-MB rise (ratio > 5%) where cTnI detected||4||0|
|cTnI rise and cardiac event||8||4|
|cTnI rise with no cardiac event||5||5|
More than half of patients undergoing emergency, and more than a quarter of those undergoing elective, aortic surgery suffer myocardial necrosis as determined by cTnI concentration. This is accompanied by an increased CK/CK-MB ratio in less than one-fifth of cases.