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체외순환 없는 관상동맥 우회술에서 혈청 크레아티닌과 트로포닌 I의 관계
정화성,김채선,김태엽 대한마취통증의학회 2009 Anesthesia and pain medicine Vol.4 No.2
Background: Renal dysfunction is an independent risk factor of cardiac dysfunction and one of common complications after cardiac surgery. This study was designed to evaluate the relationship between serum creatinine (s-Cr) and cardiac troponin I (cTnI) in off-pump coronary artery bypass graft surgery (OPCAB). Methods: Data, from 13 patients underwent OPCAB, were analyzed in prospective fashion. The levels of s-Cr and cTnI were evaluated before and after OPCAB. The correlations of s-Cr and TnI were analyzed in the patients with cardiac dysfunction assessed by low cardiac output or stroke volume at end of surgery. Results: Patients with preoperatively elevated s-Cr (female, ≥ 1.2 μg/L; male, ≥ 1.5μg/L) showed higher incidence of elevated s-Cr and elevated cTnI (≥ 0.68μg/L) on arrival at intensive care unit (POD-0), postoperative 12 hours (POD-1) and postoperative 36 hours (POD-2) (P < 0.05). Patients with preoperatively elevated cTnI showed higher incidence of elevated cTnI at POD-0, POD-1 and POD-2 (P < 0.05). In 7 patients with low cardiac index (< 2.0 L/min/m2) or stroke volume index (< 40 mL/beat/m2) at end of surgery, the increases of s-Cr and cTnI showed positive correlation at POD-0, POD-1 and POD-2 (correlation coefficient 0.818, 0.864 and 0.785, respectively). Conclusions: The increases of s-Cr and cTnI showed positive correlation in low cardiac output after OPCAB. The results suggested that elevated s-Cr may be an independent predictor of elevated cTnI representing perioperative myocardial injury.
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