Transplant International (Apr 2024)

Implications of High Sensitivity Troponin Levels After Lung Transplantation

  • Eduard Rodenas-Alesina,
  • Eduard Rodenas-Alesina,
  • Adriana Luk,
  • Adriana Luk,
  • John Gajasan,
  • Anhar Alhussaini,
  • Anhar Alhussaini,
  • Genevieve Martel,
  • Cyril Serrick,
  • Karen McRae,
  • Chris Overgaard,
  • Marcelo Cypel,
  • Marcelo Cypel,
  • Lianne Singer,
  • Lianne Singer,
  • Jussi Tikkanen,
  • Jussi Tikkanen,
  • Shaf Keshavjee,
  • Shaf Keshavjee,
  • Lorenzo Del Sorbo,
  • Lorenzo Del Sorbo,
  • Lorenzo Del Sorbo

DOI
https://doi.org/10.3389/ti.2024.12724
Journal volume & issue
Vol. 37

Abstract

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Trends in high-sensitivity cardiac troponin I (hs-cTnI) after lung transplant (LT) and its clinical value are not well stablished. This study aimed to determine kinetics of hs-cTnI after LT, factors impacting hs-cTnI and clinical outcomes. LT recipients from 2015 to 2017 at Toronto General Hospital were included. Hs-cTnI levels were collected at 0–24 h, 24–48 h and 48–72 h after LT. The primary outcome was invasive mechanical ventilation (IMV) >3 days. 206 patients received a LT (median age 58, 35.4% women; 79.6% double LT). All patients but one fulfilled the criteria for postoperative myocardial infarction (median peak hs-cTnI = 4,820 ng/mL). Peak hs-cTnI correlated with right ventricular dysfunction, >1 red blood cell transfusions, bilateral LT, use of EVLP, kidney function at admission and time on CPB or VA-ECMO. IMV>3 days occurred in 91 (44.2%) patients, and peak hs-cTnI was higher in these patients (3,823 vs. 6,429 ng/mL, p < 0.001 after adjustment). Peak hs-cTnI was higher among patients with had atrial arrhythmias or died during admission. No patients underwent revascularization. In summary, peak hs-TnI is determined by recipient comorbidities and perioperative factors, and not by coronary artery disease. Hs-cTnI captures patients at higher risk for prolonged IMV, atrial arrhythmias and in-hospital death.

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