Perioperative myocardial infarction and cardiac complications after noncardiac surgery in patients with prior myocardial infarction. III: Troponin T--a significant diagnostic alternative in perioperative myocardial infarction?

Der Anaesthesist
T MünzerW Riesen

Abstract

Diagnosis of a perioperative myocardial infarction (PMI) on the basis of measurement of the creatine kinase MB fraction (CKMB) alone is not always easy. Surgical traumatisation of muscle fibres can lead to false-positive elevations. Newly introduced laboratory tests for cardiac troponins seem to facilitate the diagnosis of PMI. We measured serum values of cardiac troponin T in 139 patients described in detail in part I and compared them with common diagnostic tools for myocardial infarction. In all, 139 patients were enrolled (part I). Clotted serum samples were taken preoperatively and daily until day 3, centrifuged, and stored at -20 degrees C until analysis. Our Department of Clinical Biochemistry and Haematology used a commercially available sandwich immunoassay (Troponin T ELISA, Boehringer, Mannheim, Germany). The measurements of CK and CKMB were performed with an automated analyser (CK, CK-MB, Boehringer, Mannheim, Germany). Serum values of troponin T were defined according to company recommendations: detection level: 0.04 ng/ml, threshold value for myocardial ischaemia: > or = 0.2 ng/ml, value for diagnosis of non-Q-wave infarction: > or = 1.0 ng/ml, and value for diagnosis of Q-wave infarction: > or = 3.0 ng/ml. We the...Continue Reading

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