Two Different Troponin Isoforms for Detection of Early Myocardial Injury after Curative Resection of Oesophageal Cancer [post]

2020 unpublished
The risk of intraoperative hypothermia, which may cause myocardial ischaemia during the early postoperative period, is relatively high in middle-aged and elderly patients undergoing curative resection of oesophageal cancer. The objective of this study was to explore the value of two troponin (cTn) subtypes, troponin I (cTnI) and high-sensitivity troponin T (hs-cTnT), which can be used to judge early myocardial injury after curative resection of oesophageal cancer. Methods: Seventy patients
more » ... venty patients undergoing elective curative resection of oesophageal cancer were randomly assigned to undergo aggressive body temperature management (nasopharyngeal temperature ≥36°C) or standard body temperature management (n = 35 in each arm). Venous blood samples were collected from the patients before the operation and at postoperative 6 h~12 h, 24 h and 48 h, and serum cTnI and hs-cTnT levels were measured. The primary outcomes included the following: (1) the incidence of myocardial injury and the relationship between hs-cTnT and cTn; and (2) the consistency and correlation of the two cTn subtypes. Results: The incidence of postoperative day 2 myocardial injury was 8.6% (3/35) among patients receiving aggressive body temperature management and 31.4% (11/35) among patients receiving standard body temperature management (P<0.05). Among 3 patients who experienced myocardial injury in the aggressive body temperature management group, 2 met the diagnostic criteria for cTnI and hs-cTnT and only 1 met the diagnostic criteria for hs-cTnT. Among the 11 patients who experienced myocardial injury in the standard body temperature management group, 7 met the diagnostic criteria for cTnI and hs-cTnT and only 3 met the diagnostic criteria for hs-cTnT; only 1 met the diagnostic criteria for cTnI. The bias of cTnI and hs-cTnT was -8.82±31.91 ng/L. The consistency limit was -71.37~53.73 ng/L. The proportion within the scope of the consistency of its corresponding boundary was 98.57%. The correlation coefficient of cTnI and hs-cTnT was 0.845 (P<0.05). Conclusions: In the evaluation of postoperative myocardial injury in patients undergoing curative resection of oesophageal cancer, cTnI and hs-cTnT exhibit high consistency and a good correlation. The combination of cTnI and hs-cTnT can improve the detection rate of myocardial injury, thus providing a better reference than a single measure alone for reducing the risk of perioperative
doi:10.21203/rs.3.rs-17140/v1 fatcat:h2q2bgomsbecbp7te6l74qmzby