Is Thyroid Surgery A Risk for Myocardial Injury?

Objective: Thyroid surgery is a widely performed non-cardiac surgical procedure. However, peri-operative myocardial injury (PMI) is the most common vascular complication associated with poor peri-operative outcomes. We aimed to investigate the effect of thyroid surgery on myocardial biomarkers during the penoperative period. Materials and Methods: A total of 98 patients (82.6% female, mean age=51.1 +/- 15.8 years) were prospectively included in the study. Patients with a previous history of cardiac diseases were excluded. Cardiac Troponin-I, creatine kinase (CK)-MB and CK levels were measured in the pre-operative period and at the 6th and 24th hours of the post-operative period. Furthermore, electrocardiography (ECG) was performed on each patient. Subsequently, the data collected at these three time points were compared. Results: Troponin-I, CK-MB, CK levels and ECG analysis of the patients who underwent thyroid surgery. The CK levels significantly increased in the postoperative 6'h hour and slightly decreased in the post-operative 24th hour (p<0.001) when compared to that in the pre-operative period. The CK-MB and troponin-I levels were not significantly different in the pen-operative period (p=0.108 and p=0.557, respectively). Moreover, no ischaemic ECG changes were observed during the peri-operative period. Conclusion: PMI does not occur in patients undergoing thyroid surgery. We also showed that thyroid tissue is not a non-cardiac origin of troponin and CK-MB. Physicians should be aware of coronary events in the pen-operative period of thyroid surgery, when elevated cardiac biomarkers are detected.