Troponin I after cardiac surgery and its implications on myocardial protection, outcomes, and cost

Laki J. Rousou, Michael D. Crittenden, Kristin B. Taylor, Nancy A. Healey, Stephen Gibson, Hemant S. Thatte, Miguel Haime, Shukri F. Khuri

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Myocardial acidosis during cardiac surgery and postoperative troponin I are markers of myocardial damage that have been shown to predict adverse outcomes. We investigated the relationship between troponin I and myocardial tissue pH, patient outcomes, and cost. Methods: Data were prospectively collected on 205 cardiac surgery patients. Troponin I was sampled upon arrival to the intensive care unit (ICU) and every 6 hours thereafter for 24 hours. The lowest pH encountered during aortic cross clamp (LpH) was related to postoperative troponin I on the multivariate level. Multivariate models were constructed to predict adverse events (AE) and cost. Results: LpH was an independent inverse determinant of postoperative troponin I (P = .0067). Troponin I and its interaction with LpH were multivariate predictors of AE (P = .0012; .0001;odds ratio = 6.9, 10.2, respectively). Troponin I independently predicts surgical ICU (SICU) cost (P = .0256). Conclusion: Postoperative troponin I elevation reflects intraoperative myocardial acidosis and damage. The strong relationship between troponin I, AE, and cost indicates the damage incurred is clinically and economically relevant. Strategies to ameliorate intraoperative myocardial tissue acidosis will decrease troponin I release, subsequent AE, and associated costs.

Original languageEnglish
Pages (from-to)703-709
Number of pages7
JournalAmerican journal of surgery
Issue number5
StatePublished - Nov 1 2008


  • Cardiac enzymes
  • Cardiac surgery
  • Cost
  • Myocardial protection
  • Myocardial tissue pH
  • Outcomes


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