Cutoff value of hs-TnI for prediction of major adverse cardiac events after coronary artery bypass grafting and risk factors for these events
Objective:To calculate the cutoff value of cardiac troponin I for predicting major adverse cardiac events (MACEs) after coronary artery bypass grafting (CABG) and identify the risk factors for MACEs after CABG.Methods:Two hundred patients who underwent CABG at Peking University People's Hospital from August 2020 to August 2021 were enrolled, and their clinical characteristics were collected. The patients were divided into a MACE group and a non-MACE group according to the occurrence of MACEs or not over a 12-day postoperative period. Clinical, laboratory, and outcome data were collected.Results:The 200 patients were classified into the MACE (n=15) and non-MACE (n=185) groups. Based on receiver operating characteristic curve analysis, the optimal joint hs-TnI, CK-MB, and MYO cut-off levels at 4~6 h after surgery for predicting postoperative MACEs were 4131.4 pg/ml, 24.9 ng/ml, and 316.5 ng/ml, respectively. The area under the curve of the thee indexes combined for predicting postoperative MACEs was 0.741 (95% confidence interval: 0.617~0.865, P=0.002), with a sensitivity of 53.3% and specificity of 85.9%. When the hs-TnI, CK-MB, and MYO levels exceeded the joint cut-off levels, the incidence of postoperative MACEs was significantly increased (Log rank P＜0.05). Cox regression analysis showed that hs-TnI level and CK-MB level were the main risk factors for MACEs after CABG (P＜0.05).Conclusion:An hs-TnI level of 4131.4 pg/ml, CK-MB level of 24.9 ng/ml, and MYO level of 316.5 ng/ml are the cutoff values for predicting MACEs after coronary artery bypass grafting. Hs-TnI level and CK-MB level are the main risk factors for MACEs after CABG.
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