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Adv Clin Path. 1998 Jan;2(1):75-83.

Biochemical markers of perioperative myocardial ischemia in patients with coronary artery bypass grafting.

Author information

1
Department of Cardio-Thoracic Surgery,University of Vienna, Vienna,1090, Austria. Friederike.Neumann@akh-wien.ac.at

Abstract

AIMS OF THE STUDY:

The evaluation of significant perioperative ischemic processes after coronary artery bypass grafting from postoperative ECG, creatine kinase (CK) and CK iso-enzyme MB remains unreliable and, hence, insufficient. Additional, early available biochemical markers could improve the diagnostics of ischemia.

METHODS:

In 86 patients with multiple vessel disease, activity of serum CK and CK-MB as well as mass of CK-MB, myoglobin and troponin-T were analyzed before and after surgery. Twelve-lead electrocardiograms were evaluated before surgery, 3h postoperatively, and before discharge from hospital.

RESULTS:

In patients with signs of perioperative ischemia in the 3-hour ECG, primary postoperative peak values of myoglobin and CK were distinctly higher than in patients without signs of ischemia, with median values of 1437 ng/ml vs. 986 ng/ml for myoglobin and of 632 U/l vs. 481 U/l (n.s.) for CK. Sensitivity and specificity of myoglobin were 64 % and 69 %, followed by CK with 61 % and 62 %, respectively.

CONCLUSIONS:

Myoglobin, indicating the risk of perioperative ischemia approximately 45 minutes after declamping of the aorta, is suggested as a candidate for early available routine monitoring.

PMID:
10358335

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