Perioperative myocardial infarction diagnosis after coronary artery bypass grafting surgery using coupled electrocardiographic changes and cardiac troponin I
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Perioperative myocardial infarction (PMI) is one of the most common causes of prolonged intensive care unit (ICU) and hospital stay after coronary artery bypass grafting (CABG) and is associated with poor prognosis and increases postoperative mortality due to the lack of accurate diagnostic methods. This study examines the association between electrocardiography (ECG) ischemic changes and cardiac troponin I concentration.
In this cross-sectional study, the ECG of 100 patients was recorded before and 24 h after the surgery. The cardiac troponin I concentration was measured 24 h after the termination of the surgery.
The average concentration of troponin I was 6.79 μg/L in the no-ECG-changes group, 11.69 μg/L in the ST depression group, 11.26 μg/L in the ST elevation group, and 27.54 μg/L in the new Q wave group. The mean troponin concentration was significantly higher in the ECG-changes group compared to no-ECG-changes group. Comparing the ECG-changes together showed significant differences between the new Q wave and the other changes. ST elevation and ST depression were not statistically significant.
The three ECG-changes groups had a higher risk of PMI after their CABG. The risk of PMI was at its highest value in the new Q wave group and at its lowest in the no-ECG-changes group.
KeywordsMyocardial infarction Troponin I Electrocardiography
We would like to express our gratitude to Dr. Masoumi, cardiac anesthesiologist at the Chamran Heart Center of Isfahan, for his assistance and contribution to the project and acknowledge Mr. Amir Salar Moazen Safaei for Proofreading this manuscript.
Arvin Shahzamani, Erfan Sheikhbahaei, Niayesh Hadi and Sara Zamani (preparing, editing, reviewing the manuscript, data acquisition, and review of literature), Shahab Shahabi (data acquisition and data analysis and reviewing the manuscript), Mehran Shahzamani (original idea, surgeon of the project, data acquisition, editing the manuscript), and Helia Hemasian (project methodology, preparing, editing, and reviewing the manuscript).
Compliance with ethical standards
Ethics approval and consent for participate
This study was carried out with an ethics approval from the Department of Ethics of the School of Medicine of Isfahan University of Medical Sciences. Informed written consent was obtained from all the patients. There were no interventions or disadvantages for the participants.
Consent for publication
The researchers refrain from using the confidential data of the participants and will not reveal and figures in their reports. All publication rights are transferred to the Indian journal of thoracic and cardiovascular surgery.
The authors declare that they have no conflict of interests.
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