Myocardial injury in patients after an elective abdominal aortic aneurysm repair

BACKGROUND The aim of the study was to study the frequency of cTnI release in patients undergoing an elective abdominal aortic aneurysm repair (AAA) and examine the relationship between an early perioperative myocardial injury, as detected by an increased serum levels of cTnI, and a clinical outcome (postoperative cardiac and non-cardiac complications, mortality). METHODS A prospective observational study of 90 patients undergoing an elective AAA repair. SETTING University hospital. Blood samples were obtained from 90 patients for cTnI assays, 8 and 24 hours after surgery. RESULTS 74.5 % of patients faced a high and medium perioperative risk (ASA III-IV). Peak postoperative cTnI concentrations above the lower detection limit of the immunoassay occurred in 22 patients. 15 of these patients (cTnI levels: 0.2-10.2 ng/ml) displayed symptoms of clinically significant complications. 9 patients (cTnI levels: 0.48-10.2 ng/ml) had serious complications (3x MI, 3x heart failure, 2x bronchopneumonia - respiratory failure, 1x sepsis), one patient died. Only 5.8 % of patients without cTnI increase had postoperative complications. A Chi-square analysis revealed a significant association between cTi elevation and postoperative complications (chi-square 38.737, p