Significant elevation of biomarkers of myocardial necrosis after coronary artery bypass grafting without myocardial infarction established assessed by cardiac magnetic resonance

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP COSTA, Leandro Menezes Alves da FMUSP-HC
HUEB, Alexandre Ciappina FMUSP-HC
VILLA, Alexandre Volney FMUSP-HC
OIKAWA, Fernando Teiichi Costa FMUSP-HC
MELO, Rodrigo Morel Vieira de FMUSP-HC
SEGRE, Carlos Alexandre Wainrober FMUSP-HC
LIMA, Eduardo Gomes FMUSP-HC
RAMIRES, Jose Antonio Franchini FMUSP-HC
dc.identifier.citation MEDICINE, v.96, n.6, article ID e6053, 7p, 2017
dc.identifier.issn 0025-7974
dc.description.abstract The release of myocardial necrosis biomarkers after off-pump coronary artery bypass grafting (OPCAB) frequently occurs. However, the correlation between biomarker release and the diagnosis of procedure-related myocardial infarction (MI) (type 5) has been controversial. This study aimed to evaluate the amount and pattern of cardiac biomarker release after elective OPCAB in patients without evidence of a new MI on cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE). Patients with normal baseline cardiac biomarkers referred for elective OPCAB were prospectively included. CMR with LGE was performed in all patients before and after interventions. Measurements of troponin I (cTnI) and creatine kinase MB fraction (CK-MB) were systematically performed before and after the procedure. Patients with new LGE on the postprocedure CMR were excluded. All of the 53 patients without CMR evidence of a procedure-related MI after OPCAB exhibited a cTnI elevation peak above the 99th percentile. In 48 (91%), the peak value was > 10 times this threshold. However, 41 (77%) had a CK-MB peak above the limit of the 99th percentile, and this peak was > 10 times the 99th percentile in only 7 patients (13%). The median peak release of cTnI was 0.290 (0.8-3.7) ng/mL, which is 50-fold higher than the 99th percentile. In contrast with CK-MB, considerable cTnI release often occurs after an elective OPCAB procedure, despite the absence of new LGE on CMR.
dc.language.iso eng
dc.relation.ispartof Medicine
dc.rights openAccess
dc.subject biomarkers; coronary artery bypass grafting; coronary artery disease; myocardial infarction; troponin
dc.subject.other mass-v trial; troponin-t; universal definition; randomized-trial; surgery; revascularization; intervention; angioplasty; mortality; diagnosis
dc.title Significant elevation of biomarkers of myocardial necrosis after coronary artery bypass grafting without myocardial infarction established assessed by cardiac magnetic resonance
dc.type article
dc.rights.holder Copyright LIPPINCOTT WILLIAMS & WILKINS LIM/11
dc.identifier.doi 10.1097/MD.0000000000006053
dc.identifier.pmid 28178154
dc.type.category original article
dc.type.version publishedVersion COSTA, Leandro Menezes Alves da:FM: HUEB, Whady:FM:MCP NOMURA, Cesar Higa:HC:INCOR HUEB, Alexandre Ciappina:HC:INCOR VILLA, Alexandre Volney:HC:INCOR OIKAWA, Fernando Teiichi Costa:HC:INCOR MELO, Rodrigo Morel Vieira de:HC:INCOR REZENDE, Paulo Cury:HC:INCOR SEGRE, Carlos Alexandre Wainrober:HC:INCOR GARZILLO, Cibele Larrosa:HC:INCOR LIMA, Eduardo Gomes:HC:INCOR RAMIRES, Jose Antonio Franchini:FM:MCP KALIL FILHO, Roberto:FM:MCP WOS:000394391200035 2-s2.0-85014126558 PHILADELPHIA USA
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dc.description.index MEDLINE
dc.identifier.eissn 1536-5964
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hcfmusp.citation.wos 1

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