{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T16:38:33Z","timestamp":1756571913199,"version":"3.41.2"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T00:00:00Z","timestamp":1679443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The impacts of elevated troponin I levels after coronary artery bypass grafting (CABG) on long-term outcomes were investigated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>A total of 996 patients who underwent elective isolated CABG for stable or unstable angina were enrolled. Patients were divided into higher and lower groups based on 80th percentile postoperative peak troponin I (ppTnI) levels. The relationship between ppTnI and long-term clinical outcomes was analysed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The median ppTnI was 1.55 (2.74) ng\/ml and was significantly higher in the conventional CABG subgroup than in the beating-heart CABG subgroup: 4.04 (4.71) vs 1.24 (1.99) ng\/ml, P\u2009&amp;lt;\u20090.001. The 80th percentile of ppTnI was 3.3\u2009ng\/ml in the beating-heart CABG subgroup and 8.9\u2009ng\/ml in the conventional CABG subgroup. In the conventional CABG subgroup (n\u2009=\u2009150), 10-year overall survival showed no significant difference between the higher (\u22658.9\u2009ng\/ml) and lower (&amp;lt;8.9\u2009ng\/ml) ppTnI groups: 71% (10%) vs 76% (5%), P\u2009=\u20090.316. However, the beating-heart CABG subgroup (n\u2009=\u2009846) showed significantly worse 10-year overall survival in the higher ppTnI group (\u22653.3\u2009ng\/ml) than in the lower ppTnI group (&amp;lt;3.3\u2009ng\/ml): 64% (6%) vs 73% (3%), P\u2009=\u20090.010. In the beating-heart CABG subgroup, multivariable analysis showed that ppTnI exceeding the 80th percentile was a risk factor for overall death (hazard ratio: 1.505, 95% confidence interval: 1.019\u20132.225, P\u2009=\u20090.040).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Higher ppTnI over the 80th percentile was associated with worse long-term survival in beating-heart CABG, but not in conventional CABG.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad087","type":"journal-article","created":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T00:35:39Z","timestamp":1679445339000},"source":"Crossref","is-referenced-by-count":4,"title":["Elevated troponin I is associated with a worse long-term prognosis in patients undergoing beating-heart coronary surgery"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8392-6014","authenticated-orcid":false,"given":"Kang Min","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital , Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8313-8053","authenticated-orcid":false,"given":"Sang Yoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital , Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4555-5782","authenticated-orcid":false,"given":"Joon Chul","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital , Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5516-0333","authenticated-orcid":false,"given":"Hyoung Woo","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital , Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4769-5340","authenticated-orcid":false,"given":"Jae Hang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital , Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0332-3430","authenticated-orcid":false,"given":"Dong Jung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital , Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4285-8200","authenticated-orcid":false,"given":"Jun Sung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital , Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0913-7014","authenticated-orcid":false,"given":"Cheong","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital , Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1111-9627","authenticated-orcid":false,"given":"Kay-Hyun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital , Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,3,22]]},"reference":[{"key":"2023052518473985300_ezad087-B1","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1016\/S0735-1097(02)02538-X","article-title":"Association between CK-MB elevation after percutaneous or surgical revascularization and three-year mortality","volume":"40","author":"Brener","year":"2002","journal-title":"J Am Coll Cardiol"},{"key":"2023052518473985300_ezad087-B2","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1053\/euhj.2002.3171","article-title":"Impact of perioperative myocardial injury on early and long-term outcome after coronary artery bypass grafting","volume":"23","author":"Steuer","year":"2002","journal-title":"Eur Heart J"},{"key":"2023052518473985300_ezad087-B3","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1001\/jama.2011.99","article-title":"Association of myocardial enzyme elevation and survival following coronary artery bypass graft surgery","volume":"305","author":"Domanski","year":"2011","journal-title":"JAMA"},{"key":"2023052518473985300_ezad087-B4","doi-asserted-by":"crossref","first-page":"1758","DOI":"10.1016\/j.athoracsur.2005.04.040","article-title":"Cardiac troponin I release after coronary artery bypass grafting operation: effects on operative and midterm survival","volume":"80","author":"Paparella","year":"2005","journal-title":"Ann Thorac Surg"},{"key":"2023052518473985300_ezad087-B5","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1002\/clc.20579","article-title":"Value of early cardiac troponin I to predict long-term adverse events after coronary artery bypass graft surgery in patients presenting with acute coronary syndromes","volume":"32","author":"Amin","year":"2009","journal-title":"Clin Cardiol"},{"key":"2023052518473985300_ezad087-B6","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1016\/j.athoracsur.2008.12.063","article-title":"Biochemical injury markers and mortality after coronary artery bypass grafting: a systematic review","volume":"87","author":"Pet\u00e4j\u00e4","year":"2009","journal-title":"Ann Thorac Surg"},{"key":"2023052518473985300_ezad087-B7","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1097\/00000542-200308000-00007","article-title":"Short- and long-term prognostic value of postoperative cardiac troponin I concentration in patients undergoing coronary artery bypass grafting","volume":"99","author":"Fellahi","year":"2003","journal-title":"Anesthesiology"},{"key":"2023052518473985300_ezad087-B8","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1161\/CIRCULATIONAHA.105.602370","article-title":"Relationship between postoperative cardiac troponin I levels and outcome of cardiac surgery","volume":"114","author":"Croal","year":"2006","journal-title":"Circulation"},{"key":"2023052518473985300_ezad087-B9","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1007\/s00059-004-2543-y","article-title":"Comparison of cardiac troponin I versus T and creatine kinase MB after coronary artery bypass grafting in patients with and without perioperative myocardial infarction","volume":"29","author":"Peivandi","year":"2004","journal-title":"Herz"},{"key":"2023052518473985300_ezad087-B10","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1016\/j.amjcard.2010.04.038","article-title":"Long-term prognostic value of cardiac troponin I and T versus creatine kinase-MB mass after cardiac surgery in low-risk patients with stable symptoms","volume":"106","author":"Vikenes","year":"2010","journal-title":"Am J Cardiol"},{"key":"2023052518473985300_ezad087-B11","doi-asserted-by":"crossref","first-page":"R106","DOI":"10.1186\/cc6126","article-title":"Determination of the threshold of cardiac troponin I associated with an adverse postoperative outcome after cardiac surgery: a comparative study between coronary artery bypass graft, valve surgery, and combined cardiac surgery","volume":"11","author":"Fellahi","year":"2007","journal-title":"Crit Care"},{"key":"2023052518473985300_ezad087-B12","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1016\/S0003-4975(00)02152-4","article-title":"Cardiac troponin I release after open heart surgery: a marker of myocardial protection?","volume":"70","author":"Vermes","year":"2000","journal-title":"Ann Thorac Surg"},{"key":"2023052518473985300_ezad087-B13","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.1016\/j.jacc.2018.08.1038","article-title":"Fourth universal definition of myocardial infarction (2018)","volume":"72","author":"Thygesen","year":"2018","journal-title":"J Am Coll of Cardiol"},{"key":"2023052518473985300_ezad087-B14","doi-asserted-by":"crossref","first-page":"2388","DOI":"10.1093\/eurheartj\/ehab918","article-title":"High-sensitivity cardiac troponin I after coronary artery bypass grafting for post-operative decision-making","volume":"43","author":"Omran","year":"2022","journal-title":"Eur Heart J"},{"key":"2023052518473985300_ezad087-B15","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/j.ahj.2012.05.027","article-title":"Troponin T is a better predictor than creatine kinase-MB of long-term mortality after coronary artery bypass graft surgery","volume":"164","author":"S\u00f8raas","year":"2012","journal-title":"Am Heart J"},{"key":"2023052518473985300_ezad087-B16","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1378\/chest.114.2.482","article-title":"Troponin I, troponin T, or creatine kinase-MB to detect perioperative myocardial damage after coronary artery bypass surgery","volume":"114","author":"Bonnefoy","year":"1998","journal-title":"Chest"},{"key":"2023052518473985300_ezad087-B17","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1016\/j.jacc.2013.08.720","article-title":"Consideration of a new definition of clinically relevant myocardial infarction after coronary revascularization","volume":"62","author":"Moussa","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2023052518473985300_ezad087-B18","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1161\/01.CIR.0000109489.71945.BD","article-title":"Effects of off-pump versus on-pump coronary surgery on reversible and irreversible myocardial injury","volume":"109","author":"Selvanayagam","year":"2004","journal-title":"Circulation"},{"key":"2023052518473985300_ezad087-B19","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.ejcts.2006.01.041","article-title":"Impact of avoiding cardiopulmonary bypass for coronary surgery on perioperative cardiac enzyme release and survival","volume":"29","author":"Kuduvalli","year":"2006","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023052518473985300_ezad087-B20","first-page":"373","volume-title":"Cardiac Surgery in the Adult Fifth Edition","author":"Cohn","year":"2017","edition":"5th edn."},{"key":"2023052518473985300_ezad087-B21","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/S0735-1097(97)00506-8","article-title":"Myonecrosis after revascularization procedures","volume":"31","author":"Califf","year":"1998","journal-title":"J Am Coll Cardiol"},{"key":"2023052518473985300_ezad087-B22","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/S0022-2828(84)80609-4","article-title":"Early enzyme release from myocardial cells is not due to irreversible cell damage","volume":"16","author":"Piper","year":"1984","journal-title":"J Mol Cell Cardiol"},{"key":"2023052518473985300_ezad087-B23","doi-asserted-by":"crossref","first-page":"1912","DOI":"10.1093\/clinchem\/44.9.1912","article-title":"Different intracellular compartmentations of cardiac troponins and myosin heavy chains: a causal connection to their different early release after myocardial damage","volume":"44","author":"Bleier","year":"1998","journal-title":"Clin Chem"},{"key":"2023052518473985300_ezad087-B24","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S0003-4975(10)61559-7","article-title":"CK-MB release following coronary artery bypass grafting in the absence of myocardial infarction","volume":"35","author":"Lee","year":"1983","journal-title":"Ann Thorac Surg"},{"key":"2023052518473985300_ezad087-B25","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.jtcvs.2020.02.035","article-title":"Ten-year outcomes after off-pump versus on-pump coronary artery bypass grafting: insights from the Arterial Revascularization Trial","volume":"162","author":"Taggart","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023052518473985300_ezad087-B26","doi-asserted-by":"crossref","first-page":"I","DOI":"10.1161\/CIRCULATIONAHA.105.001651","article-title":"Long-term results after systematic off-pump coronary artery bypass graft surgery in 1000 consecutive patients","volume":"114","author":"El-Hamamsy","year":"2006","journal-title":"Circulation"},{"key":"2023052518473985300_ezad087-B27","doi-asserted-by":"crossref","first-page":"2359","DOI":"10.1056\/NEJMoa1601564","article-title":"Five-year outcomes after off-pump or on-pump coronary-artery bypass grafting","volume":"375","author":"Lamy","year":"2016","journal-title":"N Engl J Med"},{"key":"2023052518473985300_ezad087-B28","doi-asserted-by":"crossref","first-page":"1836","DOI":"10.1016\/j.athoracsur.2010.12.043","article-title":"Off-pump and on-pump coronary artery bypass grafting are associated with similar graft patency, myocardial ischemia, and freedom from reintervention: long-term follow-up of a randomized trial","volume":"91","author":"Puskas","year":"2011","journal-title":"Ann Thorac Surg"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezad087\/49591092\/ezad087.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/63\/5\/ezad087\/50453685\/ezad087.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/63\/5\/ezad087\/50453685\/ezad087.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T19:40:24Z","timestamp":1685043624000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezad087\/7083436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,22]]},"references-count":28,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezad087","relation":{},"ISSN":["1873-734X"],"issn-type":[{"type":"electronic","value":"1873-734X"}],"subject":[],"published-other":{"date-parts":[[2023,5,1]]},"published":{"date-parts":[[2023,3,22]]},"article-number":"ezad087"}}