Publication: Association of Post-Operative Cardiac Enzyme Levels with Early Mortality Following Coronary Artery Bypass Grafting
Date
2026
Article Type
Original Article
Journal Title
Journal ISSN
1999-6217
Volume Title
Pages
Pages: 167 - 172
Publisher
Nepal Health Research Council
Abstract
Abstract:
Background: Post-operative myocardial injury is an important determinant for mortality and morbidity following Coronary Artery Bypass Graft surgery. This study evaluated the role of serial post-operative cardiac biomarker and enzyme (CK-MB, Troponin I) measurement in predicting in-hospital mortality following CABG surgery.
Methods: This retrospective study included patients undergoing CABG procedure at Manmohan Cardiothoracic Centre from January 2020 to January 2021. Cardiac Biomarkers (CK-MB and Troponin I) were measured at 6,12 and 24 hours post-operatively. The Mann–Whitney U test was used for comparison of biomarkers between survivors (n=40) and non-survivors (n=3). Receiver Operating Characteristic (ROC) curve analysis with Youden Index was used to determine optimal cutoffs values.
Results: A total of 43 patients were enrolled in the study. In-hospital mortality was 7% (3/43) with 40 survivors and 3 non-survivors. No significant differences were observed in cardiac enzymes measured at 6 hours, between the survivors and non-survivors (Troponin I, p=0.206; CK-MB, p=0.391). However, biomarkers were significantly higher in non-survivors at 12 hours (Troponin I p=0.038; CK-MB p=0.004) and 24 hours (Troponin I p=0.007; CK-MB p=0.005). ROC demonstrated excellent predictive performance of CK-MB at 12 hours (AUC=1.00, cutoff at 146 IU/L, sensitivity 100%, specificity 100%), CK-MB at 24 hours (AUC =0.95, cutoff at 155 IU/L) and Troponin I at 24 hours (AUC=0.92, cutoff at 5.17ng/ml). However, these findings should be interpreted cautiously due to only three mortality events.
Conclusions: Post operative Cardiac biomarkers (Troponin I >5.17 ng/ml at 24 hours and CK-MB >146 IU/L at 12 hours and >155 IU/L at 24 hours) were associated with in-hospital mortality following CABG and warrants further evaluation as a post-operative risk stratification marker.
Keywords: Cardiac biomarkers; coronary artery bypass surgery; creatine kinase MB; myocardial injury; troponin I.
Description
Prashiddha Bikram Kadel
Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Centre, Maharajgunj, Kathmandu, Nepal
Anil Bhattarai
Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Centre, Maharajgunj, Kathmandu, Nepal
Ravi Kumar Baral
Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Centre, Maharajgunj, Kathmandu, Nepal
Prabhat Khakural
Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Centre, Maharajgunj, Kathmandu, Nepal
Krishnaprasad Bashyal
Kathmandu Medical College, Kathmandu, Nepal
Srijana Thapa
Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Centre, Maharajgunj, Kathmandu, Nepal
Keywords
Cardiac biomarkers, coronary artery bypass surgery, creatine kinase MB, myocardial injury, troponin I
Identifier
https://doi.org/10.33314/jnhrc.v24i01.5580