| Title | Perioperative creatine phosphokinase (CPK) and troponin I trends after elective hip surgery. | | Author(s) | Mouzopoulos G, Kouvaris C, Antonopoulos D, Stamatakos M, Tsembeli A, Mouratis G, Tzurbakis M, Safioleas M | | Institution | Orthopaedic Department of Evangelismos Hospital, Athens, Greece. gmouzop@yahoo.gr | | Source | J Trauma 2007 Aug; 63(2):388-93. | | MeSH | Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip
Biological Markers
Creatine Kinase
Female
Follow-Up Studies
Fracture Fixation, Intramedullary
Humans
Male
Myocardial Infarction
Perioperative Care
Postoperative Complications
Predictive Value of Tests
Prospective Studies
Risk Assessment
Sensitivity and Specificity
Surgical Procedures, Elective
Survival Analysis
Troponin I
| | Abstract | 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 I, in 90 patients with risk factors for coronary artery disease, undergoing hip 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 and 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 postoperatively. 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. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 17693841 |
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