INCIDENCE OF MYOCARDIAL DAMAGE AFTER VASC ULAR-SURGERY - DIAGNOSIS WITH TROPONIN IC

Objective: To compare the incidence of myocardial damages diagnosed fo llowing vascular surgery using the cardiac troponin I measurement tech nique and conventional methods. Study design: Prospective epidemiologi cal study. Patients: Fifty-four patients who underwent surgery for eit her anevrysmal disease in 28 cases or occlusive aortic disease in 26 c ases. Methods: Plasma concentration of cardiac troponin I (significant at a concentration > 1.5 ng.mL(-1)) was measured by immunoenzymofluor imetry on the second and fifth postoperative days. Conventional monito ring methods included daily electrocardiogram (EGG), enzymatic assay o f total-PCK, and measurement of plasma levels of the MB isoenzyme of p hophokinase creatin (MB-PCK) (significant at > 1 ng.mL(-1) and RI > 1. 5). Results: The cardiac troponin I measurement technique allowed the diagnosis of minor myocardial damages during the postoperative period in five patients, whereas with the conventional methods (clinical sign s, ECG, and MB-PCK) only three myocardial lesions were diagnosed. Conc lusion: The cardiac troponin I measurement technique allows diagnosis of minor myocardial damages following vascular surgery. Conventional m ethods underestimate the incidence of these damages.