AUTHOR=Rodenas-Alesina Eduard , Luk Adriana , Gajasan John , Alhussaini Anhar , Martel Genevieve , Serrick Cyril , McRae Karen , Overgaard Chris , Cypel Marcelo , Singer Lianne , Tikkanen Jussi , Keshavjee Shaf , Del Sorbo Lorenzo 

TITLE=Implications of High Sensitivity Troponin Levels After Lung Transplantation

JOURNAL=Transplant International

VOLUME=Volume 37 - 2024

YEAR=2024

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.12724

DOI=10.3389/ti.2024.12724

ISSN=1432-2277

ABSTRACT=Trends in high-sensitivity cardiac troponin I (hs-cTnI) after lung transplant (LT) and its clinical value are not well stablished. This study aimed to determine kinetics of hs-cTnI after LT, factors impacting hs-cTnI and clinical outcomes. LT recipients from 2015-2017 at Toronto General Hospital were included. Hs-cTnI levels were collected at 0-24h, 24-48h and 48-72h after LT. The primary outcome was invasive mechanical ventilation (IMV)>3 days. 206 patients received a LT (median age 58, 35.4% women; 79.6% double LT). All patients but one fulfilled the criteria for postoperative myocardial infarction (median peak hs-cTnI=4820ng/ml). Peak hs-cTnI correlated with right ventricular dysfunction, >1 red blood cell transfusions, bilateral LT, use of EVLP, kidney function at admission and time on CPB or VA-ECMO. IMV>3 days occurred in 91 (44.2%) patients, and peak hs-cTnI was higher in these patients (3823 vs 6429ng/mL, p<0.001 after adjustment). Peak hs-cTnI was higher among patients with had atrial arrhythmias or died during admission. No patients underwent revascularization. In summary, peak hs-TnI is determined by recipient comorbidities and perioperative factors, and not by coronary artery disease. Hs-cTnI captures patients at higher risk for prolonged IMV, atrial arrhythmias and in-hospital death.