Sex-Specific Troponin and Creatine Kinase Thresholds After Coronary Bypass Surgery.
Ann Thorac Surg
; 2024 Jul 02.
Article
in En
| MEDLINE
| ID: mdl-38964702
ABSTRACT
BACKGROUND:
The impact of sex-differences on the release of cardiac biomarkers after coronary artery bypass grafting (CABG) remains unknown. The aim of our study was to (1) investigate the impact of sex-differences in cardiac biomarker release after CABG and (2) determine sex-specific thresholds for high-sensitivity cardiac troponin (hs-cTn) and creatine kinase-myocardial band (CK-MB) associated with 30-day major adverse cardiovascular events (MACE) and mortality.METHODS:
A consecutive cohort of 3687 patients, comprising 643 women (17.4%) and 3044 men (82.6%), undergoing CABG from 2008 to 2021 in 2 tertiary university centers with serial postoperative cTn and CK-MB measurement was analyzed. The composite primary outcome was MACE at 30 days. Secondary end points were 30-day mortality and 5-year mortality and MACE. Sex-specific thresholds for cTn and CK-MB were determined.RESULTS:
Lower levels of cTn were found in women after CABG (69.18 vs 77.57 times the upper reference limit [URL]; P < .001). The optimal threshold value for cTn was calculated at 94.36 times the URL for female patients and 206.07 times the URL for male patients to predict 30-day MACE. Female patients missed by a general threshold had increased risk for MACE or death within 30 days (cTn MACE odds ratio [OR], 3.78; 95% CI, 1.03-13.08; P = .035; death OR, 4.98; 95% CI, 1.20-20.61; P = .027; CK-MB MACE OR, 10.04; 95% CI, 2.07-48.75; P < .001; death OR 13.59; 95% CI, 2.66-69.47; P = .002).CONCLUSIONS:
We provide evidence for sex-specific differences in the outcome and biomarker release after CABG. Sex-specific cutoffs are necessary for the diagnosis of perioperative myocardial injury to improve outcomes of women after CABG.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Ann Thorac Surg
Year:
2024
Document type:
Article
Affiliation country:
Austria
Country of publication:
Países Bajos