Vol 13, No 2 (2011)
Published online: 2012-04-27
Prognostic value of troponin I in patients with critical leg ischemia
Chirurgia Polska 2011;13(2):93-97.
Abstract
Background: In patients with chronic critical leg ischaemia (CCLI) the lesions of other (except leg arteries)
vascular system regions are often observed.
Aim of study: The aim of the study was to assess clinical usefulness of troponin I (cTnI) measurement in patients hospitalised due to chronic critical leg ischemia (CCLI).
Material and methods: The study included 72 patients at the age of 76.3 ± 9.4 years with CCLI. The level of cTnI and enzymes: creatine kinase (CPK), CK isoenzyme MB (CK-MB) were measured in all patients during the day of admission and on the first and the second day after vascular procedure. On the same days an electrocardiogram was also performed. Patients with symptomatic and unstable coronary heart disease were not included into the study.
Results: Increased cTnI values (> 0.014 ng/ml) were found before vascular procedure in 4.2% of patients and in 12.5% of patients after procedure. There was a direct relationship between CPK, CK-MB levels, electrocardiogram result and positive (increased) cTnI before and after surgery. There were no significant differences concerning mortality rate between the group of cTnI positive and negative patients, however, a statistically significant higher myocardial infarction rate occurred in the group with positive cTnI (22.2% v. 0%; p = 0.0067). Other (extracardiac) reasons that influenced on increased cTnI troponin level during postoperative period were: perioperative decrease of the blood cell count that required ransfusion and acute renal failure.
Conclusions: Troponin I measurement in patients with CCLI has significant value to identify patients with high risk of cardiologic complications, particularly useful to diagnose silent myocardial ischemia during perioperative period.
Aim of study: The aim of the study was to assess clinical usefulness of troponin I (cTnI) measurement in patients hospitalised due to chronic critical leg ischemia (CCLI).
Material and methods: The study included 72 patients at the age of 76.3 ± 9.4 years with CCLI. The level of cTnI and enzymes: creatine kinase (CPK), CK isoenzyme MB (CK-MB) were measured in all patients during the day of admission and on the first and the second day after vascular procedure. On the same days an electrocardiogram was also performed. Patients with symptomatic and unstable coronary heart disease were not included into the study.
Results: Increased cTnI values (> 0.014 ng/ml) were found before vascular procedure in 4.2% of patients and in 12.5% of patients after procedure. There was a direct relationship between CPK, CK-MB levels, electrocardiogram result and positive (increased) cTnI before and after surgery. There were no significant differences concerning mortality rate between the group of cTnI positive and negative patients, however, a statistically significant higher myocardial infarction rate occurred in the group with positive cTnI (22.2% v. 0%; p = 0.0067). Other (extracardiac) reasons that influenced on increased cTnI troponin level during postoperative period were: perioperative decrease of the blood cell count that required ransfusion and acute renal failure.
Conclusions: Troponin I measurement in patients with CCLI has significant value to identify patients with high risk of cardiologic complications, particularly useful to diagnose silent myocardial ischemia during perioperative period.
Keywords: krytyczne niedokrwienie kończyntroponinachoroba wieńcowa
