Abstract
Myocardial infarction (MI) is an eversion carotid endarterectomy (eCEA) complication,
but most events are unknown, and true incidence and correlation remain controversial.
Routine cardiac troponin measurement is a commonly used method for assessing early
identification and treatment of MI and stratifying high-risk patients. The aim of
the present study is to evaluate the effect of troponin elevation levels following
eCEA and to investigate a possible correlation between adverse cardiovascular events
and the incidence of postoperative myocardial infarction following emergent vascular
surgery. The study included 54 patients who underwent eCEA. High-sensitive troponin
I (hsTnI) levels were routinely monitored pre- and postoperatively, with an upper
reference range of 34.5 pg/mL for men and 15.6 pg/mL for women. Increases were correlated
with demographic and clinical risk factors, as well as clinical or subclinical cardiovascular
events. hsTnI was increased in percentage (13%) postoperatively, and non-ST segment
elevation MI was diagnosed in eight patients. No patient had clinical symptoms of
MI and only two of them presented with simultaneous electrocardiographic changes.
Increased levels did not correlate with comorbidities or other surgical risk factors.
hsTnI elevation may occur in patients after eCEA and mostly correlates with silent
non-ST segment elevation MI that occurred in the early postoperative phase, indicating
a possible value as a tool for cardiovascular event diagnosis during the patient's
hospitalization.
Keywords
myocardial injury - myocardial ischemia - cardiac troponin - noncardiac surgery -
eversion carotid endarterectomy
