Comparison of troponin-I and troponin-T after pediatric cardiovascular operation

Background. Although the diagnostic value of troponin-T in childhood is documented, little is known about the significance of troponin-I. It was the aim of this study to compare the diagnostic value of troponin-I and troponin-T in children and newborns to assess the perioperative potential myocardial damage. Methods. Forty-eight children, mean, 51 +/- 54 months (mean value +/- 1 standard deviation) (range, 1 day to 204 months) undergoing cardiac operation were prospectively enrolled in the present study. Troponin-I, troponin-T, creatine kinase (CK), and the MB isoenzyme were measured before operation and postoperatively within 2 days. Results. Postoperative values of troponin-I for children undergoing extracardiac operation were in the normal range. In children with interventions through the right atrium (n = 10) the mean value increase to 6.5 +/- 6.1 mu g/L (range, 1.8 to 24.3 mu g/L) and even to a mean of 29.9 +/- 21.1 mu g/L (range, 7.5 to 90 mu g/L) (p < 0.01) in children with atrial and additional ventricular surgical approach (n 23). Troponin-I was of equal specificity and sensitivity compared to troponin-T, excepted in patients with postoperative renal failure in whom troponin-T raised to false pathological results. Conclusions. For detection of perioperative myocardial damage troponin-I shows a higher specificity than CK-MB activity and CK-MB mass. The diagnostic value of troponin-I is similar to troponin-T, but compared with troponin-T, it has the advantage of not being influenced by renal failure. (C) 1998 by The Society of Thoracic Surgeons.