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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 26, No 6, November/December 2015
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AFRICA
as a parameter alone, independently predicted medium-term
mortality andmorbidity.
37
Nagele
et al
. reported that pre-operative
hs-cTnT concentrations were significantly associated with
postoperative myocardial infarction and long-term mortality
in high-risk patients undergoing major non-cardiac surgery,
and they suggested that pre-operatively measured hs-cTnT
concentrations may be useful to identify patients at high risk for
peri-operative acute MI and increased long-term mortality after
non-cardiac surgery.
38
In our study, although cTnI and hs-cTnT concentrations were
well correlated with severity of myocardial injury and apoptosis,
hs-cTnT showed a better correlation than cTnI. In addition,
hs-cTnT concentrations were correlated with ACC and CPB
time. The results of this study indicate that increases in hs-cTnT
concentration seem to best reflect myocardial cell damage and
apoptosis. Although both cTnI and hs-cTnT may be specific
and efficacious markers of myocardial apoptosis and injury
occurring during CABG with CPB, hs-cTnT may be a more
useful marker than cTnI to detect peri-operative myocardial
apoptosis and injury.
Conclusion
Despite optimal current myocardial protection techniques,
PMI may occur during CABG surgery with CPB. Moreover,
CABG surgery may cause myocardial apoptosis. High-
sensitivity troponin T assay has lowered the detection threshold
for myocardial damage and therefore it may provide rapid
and specific detection of myocardial injury during CABG
surgery with CPB. Measurement of the change in hs-cTnT
concentrations may be useful to quantify the severity of peri-
operative myocardial injury.
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