TY - JOUR T1 - Evaluation of postoperative myocardial injury by heart-type fatty acid-binding protein in off-pump coronary artery bypass grafting surgery JO - Revista Española de Anestesiología y Reanimación (English Edition) T2 - AU - Carmona,P. AU - Mateo,E. AU - Montoro,A. AU - Alós,L. AU - Coret,M. AU - Errando,C.L. AU - Llagunes,J. AU - De Andrés,J. SN - 23411929 M3 - 10.1016/j.redare.2014.12.001 DO - 10.1016/j.redare.2014.12.001 UR - https://www.elsevier.es/en-revista-revista-espanola-anestesiologia-reanimacion-english-444-articulo-evaluation-postoperative-myocardial-injury-by-S234119291400002X AB - Background and goal of studyPostoperative myocardial infarction is a serious and frequent complication of cardiac surgery. Nonetheless, diagnosis in this context is occasionally challenging. We sought to evaluate the kinetics and diagnostic accuracy of the new biomarker “heart-type fatty acid-binding protein” (h-FABP) in the early detection of myocardial injury in patients undergoing off-pump coronary artery bypass grafting, compared with classical biomarkers. Materials and methodsA prospective study was conducted on 17 consecutive patients who underwent off-pump coronary artery bypass grafting during a 2-month period. Blood samples were drawn for measurement of myocardial ischemic injury biomarkers (h-FABP, troponin, creatine kinase [CK] and CK-MB), at baseline (T1), immediate post-coronary artery bypass grafting (T2), on ICU admission (T3), and after 4 (T4), 8 (T5), 24 (T6) and 48h (T7). Perioperative ischemic complications, defined according to electrocardiographic, echocardiographic and hemodynamic criteria, were recorded. ResultsEarlier peak biochemical marker plasma values occurred at T4 with troponin (2.9±5.2ng/mL), and at T5 with h-FABP (37.9±55.5ng/mL). Maximum values of CK and CK-MB occurred later, both in T6 (741±779 and 37±51U/L, respectively). The optimized cut-off obtained for h-FABP was 19ng/mL, providing a sensitivity and specificity of 77 and 75%, respectively, for diagnosis of perioperative ischemic injury, with an area under the ROC curve for h-FABP of 0.83 (95% CI 0.6–1.0) vs. 0.63 (95% CI 0.33–0.83) for troponin. This cut-off value for h-FABP is reached on average at T2 (mean value of h-FABP at T2: 18.9±21.5ng/mL). ConclusionThis is the first study evaluating the kinetics of h-FABP biomarker in perioperative off-pump coronary artery bypass grafting, and the cut-off value established could help to extend earlier detection of myocardial ischemia in this context. ER -