Impact of blood transfusion on troponin I levels and outcomes after cardiac surgery: a cohort study

Objectives: Increased cardiac troponin I [TI] has been suggested to be a sensitive indicator of intraoperative myocardial injury. We investigated the association of transfusion on TI levels post-surgery and outcomes in patients undergoing elective cardiac surgeries

Methods: We conducted a retrospective review of 542 patients. Patients were divided into two groups based on TI levels at 24 hours [TI24] [> 6.5 microg/L vs.

Results: Red blood cell [RBC] transfusion was found to be associated with high TI levels [odds ratio [OR] = 2.33, p = 0.007, 95% confidence interval [CI]: 1.30–4.30]. A trend was observed when aortic cross-clamp time and preoperative ejection fraction were adjusted for [OR = 2.06, p = 0.080, 95% CI: 0.90–4.70]. An association was found between aortic cross-clamp time and high TI levels in the multivariable model [OR = 1.01, p = 0.028, 95% CI: 1.00–1.02]. Elevated TI levels was associated with higher mortality [OR = 4.15, p = 0.017, 95% CI: 1.29–13.08], renal failure [OR = 2.99, p = 0.004, 95% CI: 1.41-6.32], and increased length of stay in-hospital [OR = 4.50, p = 0.020, 95% CI: 0.69-8.30]

Conclusions: RBC transfusion is associated with increased TI24 post-cardiac surgery and worse outcomes, albeit a confounding effect cannot be excluded. Larger studies are required to confirm these findings