000			03655nam a22005417a 4500
008			240807s20242024 xxu||||| |||| 00| 0 eng d
022			_a1878-0938
024			_aS1553-8389(24)00463-9 [pii]
040			_aOvid MEDLINE(R)
099			_a38719633
245			_aMarkedly elevated high-sensitivity troponin and in-hospital mortality after cardiac surgery.
251			_aCardiovascular Revascularization Medicine. 2024 May 05
252			_aCardiovasc Revasc Med. 2024 May 05
253			_aCardiovascular revascularization medicine : including molecular interventions
260			_c2024
260			_fFY2024
260			_p2024 May 05
265			_saheadofprint
265			_tPublisher
266			_d2024-08-07
266			_z2024/05/08 22:01
501			_aAvailable in print through MWHC library: 2002 - present
520			_aBACKGROUND: High-sensitivity troponin (hsTnI) is correlated with cardiac mortality; however, studies on the relationship of markedly elevated hsTnI with in-hospital mortality after cardiac surgery are sparse. Therefore, we aimed to define this relationship in order to help guide in-hospital, acute management of post-surgical patients.
520			_aCONCLUSION: Increasing hsTnI level is associated with increasing probability of in-hospital mortality and, therefore, serves as an additional, objective measure of risk to help guide in-hospital clinical management. Copyright © 2024 Elsevier Inc. All rights reserved.
520			_aMETHODS: We retrospectively analyzed all cardiac surgeries completed at our institution between January 2020 and June 2022 in which a peak hsTnI was noted to be >35x upper limit of normal (ULN = 34 ng/L). The primary outcome was in-hospital death. Subgroup analysis was performed to assess differences between coronary artery bypass grafting (CABG) and other cardiac surgeries.
520			_aRESULTS: A total of 1382 cases met inclusion criteria. The patients' mean age was 64.8 years and 68.2 % were male. Median peak hsTnI after surgery was 4202 ng/L (interquartile ratio: 2427-7654). Univariate analysis of troponin level with mortality found that for every 1000 ng/L increase in hsTnI, odds of in-hospital death increased by 3.8 % (odds ratio [OR]: 1.038; 95 % confidence interval [CI] 1.027-1.050; p < 0.0001). In a multivariate model, troponin (OR 1.02; 95 % CI 1.01-1.04; p = 0.004) maintained a significant association with in-hospital death. CABG was associated with a lower risk of in-hospital death for any given hsTnI level up to 60,000 ng/L compared to other cardiac surgeries.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
650			_zAutomated
651			_aMedStar Heart & Vascular Institute
651			_aMedStar Washington Hospital Center
656			_aAdvanced Cardiac Catheterization Research Fellowship
656			_aInterventional Cardiology Fellowship
657			_aJournal Article
700			_aAladin, Amer _bMWHC _cInterventional Cardiology Fellowship _dMBChB
700			_aBen-Dor, Itsik _bMHVI
700			_aBhogal, Sukhdeep _bMHVI
700			_aCellamare, Matteo _bMHVI
700			_aMerdler, Ilan _bMHVI
700			_aReddy, Pavan _bMWHC _cAdvanced Cardiac Catheterization Research Fellowship _dMD
700			_aRogers, Toby _bMHVI
700			_aSatler, Lowell F _bMHVI
700			_aWaksman, Ron _bMHVI
700			_aZhang, Cheng _bMHVI
790			_aReddy P, Cellamare M, Merdler I, Zhang C, Bhogal S, Aladin AI, Ben-Dor I, Satler LF, Rogers T, Waksman R
856			_uhttps://dx.doi.org/10.1016/j.carrev.2024.05.005 _zhttps://dx.doi.org/10.1016/j.carrev.2024.05.005
942			_cART _dArticle
999			_c14440 _d14440