Leal João Carlos, Petrucci Orlando, Godoy Moacir Fernandes, Braile Domingo Marcolino
Division of Cardiac Surgery, Faculty of Medicine of São José do Rio Preto, FAMERP, São José do Rio Preto, Brazil.
Interact Cardiovasc Thorac Surg. 2012 Jan;14(1):22-5. doi: 10.1093/icvts/ivr019. Epub 2011 Nov 15.
Atrial fibrillation (AF) remains a frequent complication after coronary artery bypass graft surgery (CABG). We evaluate the association of AF occurrence and serum cardiac troponin I (cTnI) levels in the early postoperative period after CABG. Between April 2009 and January 2010, 95 consecutive patients with sinus rhythm who underwent CABG were evaluated. The patients were divided into two groups according to their postoperative rhythms: sinus rhythm group (SR) and AF group (AF). Demographic, clinical variables, and troponin I were evaluated at the pre- and postoperative times. There were no clinical or demographic differences between the two groups. The postoperative troponin I in the SR group was lower than that in the AF group (0.66 ± 1.62 vs. 2.07 ± 5.01 ng/ml; P = 0.029). Using the receiver operating characteristic curves was found as the best cut-off value to predict AF occurrence at the value of 0.901 ng/ml. Using this value of cTnI, a sensitivity of 60% and a specificity of 87% for AF onset prediction were observed. The cTnI serum levels at the postoperative period after CABG were higher in patients who subsequently developed AF. The cut-off value of 0.901 ng/ml is useful for prediction and preventive therapeutic actions.
心房颤动(AF)仍是冠状动脉旁路移植术(CABG)后常见的并发症。我们评估了CABG术后早期AF发生与血清心肌肌钙蛋白I(cTnI)水平之间的关联。在2009年4月至2010年1月期间,对95例连续接受CABG且术前为窦性心律的患者进行了评估。根据术后心律将患者分为两组:窦性心律组(SR)和AF组(AF)。在术前和术后评估人口统计学、临床变量及肌钙蛋白I。两组之间在临床或人口统计学方面无差异。SR组术后肌钙蛋白I低于AF组(0.66±1.62 vs. 2.07±5.01 ng/ml;P = 0.029)。通过绘制受试者工作特征曲线发现,预测AF发生的最佳截断值为0.901 ng/ml。采用该cTnI值时,预测AF发作的敏感性为60%,特异性为87%。CABG术后发生AF的患者术后cTnI血清水平较高。0.901 ng/ml的截断值有助于预测及采取预防性治疗措施。