Can cardiac troponins be used to diagnose a perioperative myocardial infarction post cardiac surgery?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether Troponin I or T can effectively diagnose a perioperative myocardial infarction after cardiac surgery. Altogether 191 papers were found using the reported search, of which 17 presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these papers are tabulated. We conclude that Troponin I and T can both be used to indicate myocardial damage, with the level correlating well with the level of injury. However until issues such as a 'gold standard' for peri-operative MI are addressed, one single cut-off point cannot be recommended for either test.