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Leo Pölzl¹, Joseph Kletzer², Ronja Lohmann¹

¹Department of Cardiac Surgery, Medical University of Innsbruck, Tyrol, Innsbruck, Austria.

|September 24, 2025

概括

在手术前,高灵敏度的托邦素T (hs-cTnT) 升高预测了选择性冠状动脉旁路移植 (CABG) 的不良结果. 升高的hs-cTnT可以识别高风险患者,指导治疗决策并改善临床结果.

科学领域:

心脏病学心脏病学
心脏外科手术心脏外科手术
生物标志物生物标志物

背景情况:

在接受选择性冠状动脉旁路移植 (CABG) 的患者中,术前高灵敏度托波宁T (hs-cTnT) 的升高可能表明心肌脆弱性.
这一漏洞可能会影响外科手术时间和术后管理策略.

研究的目的:

研究术前hs-cTnT水平与术后结果之间的关联.
评估hs-cTnT水平与短期和长期死亡率之间的联系.
增强选择性CABG患者的风险分层和临床决策.

主要方法:

在2010年至2023年期间,对5450名接受选择性CABG的患者进行了回顾性分析.
根据手术前的hs-cTnT水平,患者被分为三组:非升高 (<1xURL),轻度升高 (1-3xURL) 和显著升高 (>3xURL).
使用倾向性评分权重来评估hs-cTnT与术后结果和死亡率 (30天和5年) 的关联.

主要成果:

26.6%的患者hs-cTnT>1xURL,12.4%的患者hs-cTnT>3xURL.
显著增加的hs-cTnT (>3xURL) 与使用ECMO (HR:2.96),血液过 (HR:2.99) 和5年死亡率 (HR:1.55) 的风险增加有关 (所有P<0.001).
轻度hs-cTnT升高 (1-3xURL) 也与更高的血过率 (HR: 2.25),ECMO使用 (HR: 1.65) 和5年死亡率 (HR: 1.37) (所有P<0.05) 相关.

结论:

手术前的hs-cTnT是可选CABG中不良结果的独立预测器.
常规的手术前hs-cTnT评估可以识别高风险个体.
整合hs-cTnT可以优化手术时间和指导治疗选择 (CABG与PCI),改善患者的治疗结果.

关键词:

根据CABG的规定.生物标志物生物标志物心脏外科手术的心脏手术心脏中的托罗邦尼 (troponin)风险分层的风险分层.

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