DIFFERENTIATION BETWEEN TRANSMURAL PERIOPERATIVE MYOCARDIAL-INFARCTION AND SUBENDOCARDIAL INJURY AFTER CORONARY-ARTERY BYPASS-GRAFTING USING BIOCHEMICAL TESTS, ELABORATED BY CLUSTER AND DISCRIMINANT-ANALYSIS

The aim of this study is to differentiate between transmural periopera tive myocardial infarction (T-PMI) and subendocardial perioperative my ocardial injury (S-PMI) as a complication of coronary artery bypass gr afting (CABG). Seventy-three patients undergoing CABG were followed po st operatively by measuring troponin T, CK-MB isoenzyme mass concentra tion (CK-MB mass), creatine kinase MB isoenzyme activity (CK-MB activi ty), creatine kinase (CK), alpha hydroxybutyrate dehydrogenase (HBD), and aspartate aminotransferase (AST) at five sampling times. Lacking a proper definition of the gold standard for the diagnosis of periopera tive myocardial infarction, a statistical procedure was used. Supporte d by the cluster analysis method of Ward, patients were assigned to a patient group with a perioperative myocardial infarction (PMI) or a pa tient group without a PMI (non-PMI) as a confirmation of interpretatio n of the biochemical results, Using the results of electrocardiogram ( ECG) and echocardiography, the PMI patient group was split into a T-PM I patient group and a S-PMI patient group. With discriminant analysis, two canonic discriminant functions were drawn up to differentiate bet ween patients suffering from a T-PMI or S-PMI and non-PMI patients. (C ) 1998 Elsevier Science B.V. All rights reserved.