Cardiac troponin i in patients following coronary artery bypass surgery with end-stage renal disease

Objectives: Cardiac troponin I (cTnI) is a reliable marker for the detection of perioperative myocardial damage following cardiac surgery. However, little is known about cTnI levels in CABG patients with ESRD. We therefore evaluated the time course of cTnI in patients with hemodialysis-dependent ESRD undergoing CABG. Material and Methods: Between 01/2000 and 07/2003 3323 patients underwent isolated CABG. Of these, 50 patients with hemodialysis-dependent ESRD had an uneventful postoperative course (group 1). In a prospective study, cTnI levels were measured (Immunoassay, Dimension-Flex, Dade Behring Inc.) preoperatively, at 1, 6, 12, 24, 36, and 48 hours after aortic unclamping. CTnI levels were compared with 50 CABG patients with an uneventful postoperative course and normal renal function (group 2). Plasma half-life time of cTnI was calculated for both groups. Results: The mean number of distal grafts/patient was 3.6±1.1 in group 1 and 3.6±0.9 in group 2. No major complications or perioperative myocardial infarction were observed perioperatively. During cardiopulmonary bypass all ESRD patients were put on hemofilter. First hemodialysis was performed 46±19 hours postoperatively. Postoperative time course of cTnI was significantly increased in group1 compared to group 2 (P