TY - JOUR
TI - Perioperative creatine phosphokinase (CPK) and troponin I trends after
elective hip surgery
AU - Mouzopoulos, George
AU - Kouvaris, Christos
AU - Antonopoulos, Dimitrios
AU - and Stamatakos, Mihalis
AU - Tsembeli, Anastasia
AU - Mouratis, George and
AU - Tzurbakis, Mathaios
AU - Safioleas, Mihalis
JO - JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE
PY - 2007
VL - 63
TODO - 2
SP - 388-393
PB - Lippincott, Williams & Wilkins
SN - null
TODO - 10.1097/01.ta.0000241236.54304.a3
TODO - creatine kinase; troponin I; hip; myocardial infarction; orthopedic
surgery
TODO - Background: Perioperative myocardial infarction (MI) is an important
risk factor for cardiac morbidity and mortality after hip surgery. On
the basis of the limitations of creatine kinase cardiac muscle isoenzyme
(CK-MB) in the perioperative setting, and the high specificity of
troponin I, we hypothesized that troponin I would be effective at
detecting perioperative MI more frequently than CK-MB would be, after
hip surgery.
Methods: A prospective study of the serum levels of creatine
phosphokinase (CPK), its isoenzyme CK-MB, and troponin 1, in 90 patients
with risk factors for coronary artery disease, undergoing hip 14 surgery
is reported. We measured these cardiac markers in the postoperative
period for 5 days, after hemiarthroplasty, total hip arthroplasty, and
hip intramedullary nailing.
Results: We found increased levels of creatine phosphokinase and CK-MB,
after all the types of operation, with maximum levels reached on the
first postoperative day anti the levels were more pronounced after total
hip arthroplasty. False-elevated CK-MB index > 6% without MI was
evidenced in 43.3% of patients. Troponin I levels were elevated > 3.1
ng/mL only in the patients who suffered MI post-operatively. All the
patients who suffered MI had both CK-MB index and troponin I levels
elevated. Also, we found high correlation between maximum CK-MB levels
and size of implants, which means that reaming and its heating effect
may be responsible for false-elevated CK-MB levels, except direct muscle
damage caused by surgical incision.
Conclusion: CK-MB index and troponin I have the same sensitivity, but
troponin I is more specific than CK-MB index in detecting MI after hip
surgery.
ER -