Thorac Cardiovasc Surg 2011; 59 - eP158
DOI: 10.1055/s-0030-1269386

High sensitive troponin t is superior to additive Euroscore for predicting 30 and 90 day mortality in non-coronary cardiac surgery

T Hanke 1, J Hendrik 2, I Anderson 2, J Schön 2, H Heinze 2, HH Sievers 1, M Heringlake 2
  • 1UK-SH Campus Lübeck, Klinik für Herz- und thorakale Gefäßchirurgie, Lübeck, Germany
  • 2Universität zu Lübeck, Klinik für Anästhesie, Lübeck, Germany

Objectives: Highly sensitive troponin-t (hsTNT) is a cardiovascular risk marker in patients with CAD and heart failure. No data are available about the usefulness of hsTNT for risk stratification in cardiac surgery patients. We assessed the hypothesis that hsTNT is predictive of 30 and 90 day mortality in patients undergoing on-pump cardiac surgery and superior to additive Euroscore.

Methods: 819 patients during a 1 year period were studied. hsTNT, N-terminal pro B-type natriuretic peptide (NTproBNP), and additive Euroscore were determined preoperatively. Analyses were performed by Receiver-operating curve (ROC) analyses.

Results: 30/90 day mortality was 2.1/3.8% in the total cohort, 1.7/3.9% in CABG patients (n=537), and 2.8/3.9% in patients undergoing non-CABG (n=282). ROC analysis results are given in table 1.

Table 1

§: The AUC of the Euroscore failed to reach statistical significance; *: p<0.018 for AUC hsTNT vs. AUC Euroscore
Data are given as ROC – area-under-the-curve (AUC)

Add. Euroscore

NTproBNP

hsTNT

Total cohort: 30d mortality

0.78 (0.75 to 0.8)

0.79 (0.76 to 0.81)

0.77 (0.74 to 0.8)

Total cohort: 90d mortality

0.75 (0.72 to 0.78)

0.77 (0.74 to 0.8)

0.75 (0.71 to 0.78)

Coronary artery surgery:
30d mortality

0.9 (0.87 to 0.92)

0.79 (0.76 to 0.83)

0.74 (0.70 to 0.77)

Coronary artery surgery:
90d mortality

0.82 (0.79 to 0.86)

0.77 (0.73 to 0.80)

0.72 (0.68 to 0.76)

Non-coronary artery
surgery: 30d mortality

0.57 (0.51 to 0.63§

0.76 (0.70 to 0.81)

0.85 (0.80 to 0.89)*

Non-coronary artery
surgery: 90d mortality

0.56 (0.50 to 0.62)§

0.77 (0.72 to 0.82)

00.81 (0.76 to 0.85)*

Conclusion: This study confirms that the additive Euroscore has a good discrimatory capacity for mortality in CABG but not in non-CABG surgery. In contrast, the predictive capacity of hsTNT is clearly superior in patients undergoing non-coronary artery surgery. This warrants further investigations of hsTNT for risk stratification in larger populations.