Correlation Between Cardiac Troponin I And Complications After Cardiac Valve Replacement

Objective: To analyze the related factors of complications after cardiac valve replacement and the predictive value of cardiac troponin(cTnI)in postoperative complications.Methods: A retrospective analysis of clinical data of February 2015-2016 year in July 62 cases of elective cardiac valve replacement patients,including 38 cases of women(61.29%),24 cases were male(38.71%),including the main observation of postoperative complications,low cardiac output,pulmonary infection,respiratory failure,acute kidney injury,postoperative bleeding,postoperative delirium.The level of 0h cTnI was measured.ROC(Receiver operating characteristics)was used to assess the predictive value and cutoff value of troponin I in postoperative complications.Logistic was used to multivariate analysis of postoperative complications.Results: Postoperative 0h cTnI(10271.79 + 8200.93pg/ml)compared with the preoperative level(15.23 + 17.98pg/ml)increased significantly;grouped according to the postoperative complication,divided into the complication group and non complication group: between the two groups in the aortic clamping time(p=0.010),cardiopulmonary bypass time(p=0.012),operation time(p=0.003)ICU,number of days(p<0.001),postoperative 0h cTnI value(p=0.020)had significant difference;with the postoperative 0h c TnI predicted postoperative complications in ROC area under the curve was 0.68,the cut-off value of 12781.85pg/ml(p=0.019);Logistic analysis showed that cTnI> 12781.85pg/ml(OR=7.018,p=0.005),operation time more than 360 minutes(OR=24.553,p=0.025)were independent risk factors of postoperative complications;according to troponin I is greater than the cutoff value were divided into A group(<12781.85pg/ml)and group B(>12781.85pg/ml):B group of low cardiac output Pulmonary infection,with the proportion of A group had statistically significant difference(p=0.001,0.015);ROC curve analysis of cTnI for the prediction of the optimal critical value of low cardiac output is 17186.90pg/ml,the sensitivity was 69.2%,specificity 89.8%,positive predictive value 64.3%,and negative predictive value of 91.7%.There was no significant difference in the prediction of pulmonary infection.Conclusion: The 0h cTnI level increased significantly after cardiac valve replacement,aortic clamping time,CPB time,operation time was significantly prolonged and the postoperative complications related to >12781.85pg/ml,while the cTnI level is an independent risk factor of postoperative complications,postoperative cTnI levels can predict the complications of cardiac valve replacement,particular low cardiac output syndrome.