Park Jungchan, Lee Seung Hwa, Han Sangbin, Jee Hyun Sook, Lee Suk-Koo, Choi Gyu-Seong, Kim Gaab Soo
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
PLoS One. 2017 May 23;12(5):e0177838. doi: 10.1371/journal.pone.0177838. eCollection 2017.
This study was aimed to evaluate the association between preoperative high-sensitivity cardiac troponin I (hs-cTnI) level and mortality in patients undergoing liver transplantation (LT). From January 2011 to May 2016, preoperative hs-cTnI level was measured in consecutive 487 patients scheduled for LT. Patients with elevated preoperative hs-cTnI were compared with those who had normal level. The primary outcome was all-cause death in follow-up period of 30 days to 1 year after operation. Of the 487 patients, 58 (11.9%) had elevated preoperative hs-cTnI and 429 (88.1%) had normal preoperative hs-cTnI. In multivariate analysis, the rate of 1-year mortality and 30-day mortality were higher in elevated preoperative hs-cTnI group (hazard ratio [HR], 3.69; confidence interval [CI] 95%, 1.83-7.42; p < 0.001, HR, 6.61; CI, 1.91-22.82; p = 0.003, respectively). After adjustment with inverse probability weighting (IPW), the incidence of 1-year mortality and 30-day mortality were higher in elevated group (HR, 4.66; CI, 3.56-6.1; p < 0.001, HR, 10.31; CI, 6.39-16.66; p < 0.001, respectively). In conclusion, this study showed that in patients who underwent LT, elevation of preoperative hs-cTnI level was associated with 1-year mortality and 30-day mortality.
本研究旨在评估肝移植（LT）患者术前高敏心肌肌钙蛋白I（hs-cTnI）水平与死亡率之间的关联。2011年1月至2016年5月，对连续487例计划接受LT的患者测量了术前hs-cTnI水平。将术前hs-cTnI升高的患者与水平正常的患者进行比较。主要结局是术后30天至1年随访期内的全因死亡。487例患者中，58例（11.9%）术前hs-cTnI升高，429例（88.1%）术前hs-cTnI正常。多因素分析显示，术前hs-cTnI升高组1年死亡率和30天死亡率更高（风险比[HR]分别为3.69；95%置信区间[CI]为1.83 - 7.42；p < 0.001，HR为6.61；CI为1.91 - 22.82；p = 0.003）。经逆概率加权（IPW）调整后，升高组1年死亡率和30天死亡率的发生率更高（HR分别为4.66；CI为3.56 - 6.1；p < 0.001，HR为10.31；CI为6.39 - 16.66；p < 0.001）。总之，本研究表明，在接受LT的患者中，术前hs-cTnI水平升高与1年死亡率和30天死亡率相关。
