Impact of blood transfusion on troponin i levels and outcomes after cardiac surgery : a cohort study

الملخص EN

Objectives : increased cardiac troponin i (ti) has been suggested to be a sensitive indicator of intraoperative myocardial injury.

we investigated the association of transfusion on ti levels post-surgery and outcomes in patients undergoing elective cardiac surgeries.

Methods : we conducted a retrospective review of 542 patients.

patients were divided into two groups based on ti levels at 24 hours (ti24) (> 6.5 μg/l vs.

≤ 6.5 μg/l).

the impact of transfusion on ti levels was estimated using logistic regression and adjusted for using a multivariable model that included aortic cross-clamp time and preoperative ejection fraction.

the effect of ti on the clinical outcomes was examined.

Results : red blood cell (rbc) transfusion was found to be associated with high ti levels (odds ratio (or) = 2.33, p = 0.007, 95% confidence interval (ci): 1.30–4.30).

a trend was observed when aortic cross-clamp time and preoperative ejection fraction were adjusted for (or = 2.06, p = 0.080, 95% ci: 0.90–4.70).

an association was found between aortic cross-clamp time and high ti levels in the multivariable model (or = 1.01, p = 0.028, 95% ci: 1.00–1.02).

elevated ti levels was associated with higher mortality (or = 4.15, p = 0.017, 95% ci: 1.29–13.08), renal failure (or = 2.99, p = 0.004, 95% ci: 1.41–6.32), and increased length of stay in-hospital (or = 4.50, p = 0.020, 95% ci: 0.69–8.30).

conclusions : rbc transfusion is associated with increased ti24 post-cardiac surgery and worse outcomes, albeit a confounding effect cannot be excluded.

larger studies are required to confirm these findings.