Abstract
The study analysed the level of troponin I (Tn) in the blood in patients with coronary artery disease after coronary artery bypass grafting in comparison with patients after aortic valve replacement surgery. The dynamics of troponin in the early postoperative period was studied, a parallelism was established between the occurrence of complications after surgery and the degree of myocardial damage. A new method has been developed for assessing the degree of intraoperative myocardial damage and the risk of complications using the «index of myocardial damage», the Tn level is determined twice after the operation, in the period up to 6 hours – Tn early and 12–24 hours later – Tn late, the index is calculated as the ratio of Tn late one to Tn early one. A correlation analysis of the «index» with other laboratory parameters was carried out, as a result of which no significant correlations were found, which indicates the absence of duplication and the significance of the developed indicator for assessing myocardial damage after cardiac surgery.
Highlights
SUMMARY The study analysed the level of troponin I (Tn) in the blood in patients with coronary artery disease after coronary artery bypass grafting in comparison with patients after aortic valve replacement surgery
The dynamics of troponin in the early postoperative period was studied, a parallelism was established between the occurrence of complications after surgery and the degree of myocardial damage
A new method has been developed for assessing the degree of intraoperative myocardial damage and the risk of complications using the «index of myocardial damage», the Tn level is determined twice after the operation, in the period up to 6 hours – Tn early and 12–24 hours later – Tn late, the index is calculated as the ratio of Tn late one to Tn early one
Summary
Разработан новый метод оценки степени интраоперационного повреждения миокарда и риска развития послеоперационных осложнений с помощью индекса повреждения миокарда, для чего концентрацию тропонина I (Tn) определяют после операции дважды – в период до 6 часов – Tn ранний и через 12–24 часа – Tn поздний, рассчитывают индекс как отношение Tn позднего к Tn раннему. Проведен корреляционный анализ индекса с другими лабораторными показателями, в результате которого не было выявлено достоверных корреляций, что говорит об отсутствии дублирования и значимости разработанного показателя для оценки повреждения миокарда после проведения операций на сердце. Среди кардиологов и специалистов лабораторной медицины нет единого мнения, как лучше оценить динамику кардиомаркеров в послеоперационном периоде, в какое время оптимально проводить взятие крови, а также как применить полученные лабораторные данные для оценки степени повреждения миокарда.
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