Troponindynamik nach herzchirurgischem Eingriff

The diagnostics of myocardial infarction are possible with laboratory analyses of cardiac markers, in particular the highly sensitive cardiac troponin, with high sensitivity and specificity and established in synopsis with the appropriate symptoms and changes in the electrocardiogram (ECG). Following cardiac surgery, troponin release can occur as an expression of procedural myocardial injury due to myocardial manipulation or the use of cardioplegia. Consequently, diagnosing perioperative myocardial infarction is challenging but of utmost clinical relevance. Studies have shown that elevated troponin levels within the first 48 h postoperatively correlate with increased mortality after cardiac surgery. The B‑ACS pilot study investigated the troponin dynamics of 412 cardiac surgery patients, revealing significant differences in troponin levels between patients with postoperative ST-elevation myocardial infarction (STEMI) and those without any complications. Additionally, significant differences in the postoperative troponin dynamics between the genders were observed. The results of the B‑ACS pilot study suggest that troponin is a suitable biomarker for diagnosing perioperative myocardial infarction and that early postoperative serial troponin monitoring following cardiac surgery could improve the identification of patients at increased risk and consequently their outcome.