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Association of cardiac troponin, CK-MB, and postoperative myocardial ischemia with long-term survival after major vascular surgery

Giora Landesberg, MD, DSc^*,*, Vadim Shatz, MD^*, Inna Akopnik, MD, Yehuda G. Wolf, MD, Michael Mayer, DSc, Yacov Berlatzky, MD, Charles Weissman, MD^* and Morris Mosseri, MD^||

^* Department of Anesthesiology, Jerusalem, Israel
Department of Critical Care Medicine, Jerusalem, Israel
Vascular Surgery, Jerusalem, Israel
Clinical Biochemistry, Jerusalem, Israel
^|| Cardiology at Hadassah Medical Center, Jerusalem, Israel

View larger version (22K): [in a new window]   Figure 1 Kaplan-Meier survival curves of all patients divided according to their highest postoperative troponin level: Group I—cTn-I 0.6 ng/ml and cTn-T 0.03 ng/ml; Group II—0.6 ng/ml < cTn-I 1.5 ng/ml and/or 0.03 ng/ml < cTn-T 0.1 ng/ml; Group III—1.5 ng/ml < cTn-I 3.1 ng/ml and/or 0.1 ng/ml < cTn-T 0.2 ng/ml; Group IV—cTn-I > 3.1 ng/ml and/or cTn-T > 0.2 ng/ml; Groups II, III, and IV had worse long-term survival than Group I (p = 0.047, 0.007, and 0.001, respectively, by log-rank test). cTn = cardiac troponin.

View larger version (20K): [in a new window]   Figure 2 Kaplan-Meier survival curves of all patients divided according to their highest postoperative creatine kinase-MB fraction (CK-MB) level: Group I—CK-MB 5%; Group II—5% < CK-MB 10%; Group III—CK-MB >10%; Groups II and III had worse long-term survival than Group I (p = 0.01 and 0.001, respectively, by log-rank test).

View larger version (22K): [in a new window]   Figure 3 Kaplan-Meier survival curves of all patients divided according to their longest postoperative ischemia duration: Group I—ischemia duration <15 min; Group II—15 min < ischemia duration > 30 min; Group III—ischemia duration >30 min. Group III had worse long-term survival than Group I (p = 0.008, by log-rank test).