What the study found
Cardiac troponin T and cardiac troponin I, two heart muscle injury biomarkers, showed different postoperative levels after coronary artery bypass graft surgery. These differences affected how often patients met existing definitions of perioperative myocardial infarction, meaning heart injury around the time of surgery.
Why the authors say this matters
The authors conclude that the different behavior of cardiac troponin T and I has an impact on current criteria for perioperative myocardial infarction. The study suggests that the biomarker used may change whether a patient meets guideline-based thresholds.
What the researchers tested
The researchers studied adults older than 18 years who underwent isolated coronary artery bypass graft surgery. They measured cardiac troponin T and I in the same patients using the same blood samples, and included only patients with patent bypass grafts on postoperative computed tomography and no at least 10% decrease in left ventricular ejection fraction, indicating an uneventful postoperative course. They then applied perioperative myocardial infarction criteria from the Universal Definition of Myocardial Infarction, Academic Research Consortium-2, and VISION.
What worked and what didn't
The study included 258 patients with a median age of 69 years. Median peak postoperative troponin values were 349 ng/L for cardiac troponin T and 1517 ng/L for cardiac troponin I, with peaks most often seen on the first postoperative day. The biomarker cutoffs were exceeded more often for cardiac troponin I than for cardiac troponin T under all three definitions; when echocardiogram and electrocardiogram criteria were also included, the differences became smaller but remained.
What to keep in mind
The summary does not describe limitations beyond the study population and design. The findings apply to patients with isolated coronary artery bypass graft surgery and an uneventful postoperative course as defined in the study.
Key points
- Cardiac troponin T and I had different postoperative concentrations after coronary artery bypass graft surgery.
- Troponin I exceeded perioperative myocardial infarction biomarker cutoffs more often than troponin T.
- The comparison used the same patients and the same blood samples for both biomarkers.
- The study applied criteria from the Universal Definition of Myocardial Infarction, Academic Research Consortium-2, and VISION.
- Differences between troponin T and I were smaller when echocardiogram and ECG criteria were added.
Disclosure
- Research title:
- Troponin T and I differ after bypass surgery and affect infarction criteria
- Authors:
- Luca Koechlin, Islam Salikhanov, Ivo Strebel, Brigitta Gahl, Brian Mawad, Niccolo Landert, Luise Vöhringer, Oliver Reuthebuch, Philip Haaf, Michael Zellweger, Martin Siegemund, Christian Müller, Denis Berdajs
- Institutions:
- Hospital Base, Hospital Base, Hospital Base, Hospital Base, Hospital Base, Hospital Base, Hospital Base, Hospital Base, Hospital Base, University Hospital Zurich, University of Basel, University of Basel, University of Basel, University of Basel, University of Basel
- Publication date:
- 2026-04-20
- OpenAlex record:
- View
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