Comparison of troponin-I and troponin-T after pediatric cardiovascular operation

Background. Although the diagnostic value of troponin-T in childhood is doc umented, little is known about the significance of troponin-I. It was the a im of this study to compare the diagnostic value of troponin-I and troponin -T in children and newborns to assess the perioperative potential myocardia l damage. Methods. Forty-eight children, mean, 51 +/- 54 months (mean value +/- 1 sta ndard deviation) (range, 1 day to 204 months) undergoing cardiac operation were prospectively enrolled in the present study. Troponin-I, troponin-T, c reatine kinase (CK), and the MB isoenzyme were measured before operation an d postoperatively within 2 days. Results. Postoperative values of troponin-I for children undergoing extraca rdiac operation were in the normal range. In children with interventions th rough the right atrium (n = 10) the mean value increase to 6.5 +/- 6.1 mu g /L (range, 1.8 to 24.3 mu g/L) and even to a mean of 29.9 +/- 21.1 mu g/L ( range, 7.5 to 90 mu g/L) (p < 0.01) in children with atrial and additional ventricular surgical approach (n 23). Troponin-I was of equal specificity a nd sensitivity compared to troponin-T, excepted in patients with postoperat ive renal failure in whom troponin-T raised to false pathological results. Conclusions. For detection of perioperative myocardial damage troponin-I sh ows a higher specificity than CK-MB activity and CK-MB mass. The diagnostic value of troponin-I is similar to troponin-T, but compared with troponin-T , it has the advantage of not being influenced by renal failure. (C) 1998 b y The Society of Thoracic Surgeons.