Objective: To determine whether there are sex-based differences in serum troponin I (TnI) after cardiac surgery with cardiopulmonary bypass.
Design: Prospective, observational, cohort study.
Setting: Tertiary cardiac surgery intensive care unit (ICU) at a university hospital.
Interventions: None.
Measurements and Main Results: Serum TnI was measured in samples obtained at ICU admission and 6, 12, 24, and 48 hours later. A total of 761 consecutive patients were studied (444 men and 317 women). The characteristics and results of the different sex subgroups were as follows:
A) Coronary bypass: 165 men and 38 women. Age, Parsonnet score, Acute Physiology and Chronic Health Evaluation III score, prevalence of renal failure, intra-aortic balloon use, and the lengths of cardiopulmonary bypass, mechanical ventilation, and ICU stay were similar in the two groups. Body mass index, red-cell transfusion needs, and use of noradrenaline were significantly higher in women, whereas dobutamine requirements were higher in men. Mortality: 3 men (1.6%) vs. 0 women (p = not significant).
The TnI peak was slightly, but significantly, higher in men (6.2 ± 4.9 vs. 4.5 ± 2.6 μg/L. p < 0.05).
B) Valve surgery: 279 men and 279 women. Some significant differences were found: Women were older than men and had higher Parsonnet score and transfusion needs. The other recorded variables were similar. Mitral prosthesis: 62 men and 125 women (p < 0.05). Mitral valvuloplasty: 24 men, 7 women (p < 0.05). Aortic prosthesis: 162 men, 103 women (p < 0.05). Mitral and aortic prosthesis: 31 men and 44 women (p < 0.05). TnI peaks were similar for both sexes in each valve subgroup. Mortality: 3 men (1%) vs. 11 women (3.4%) (p < 0.05).
The TnI peak did not reach any significant differences between sexes (men 7.9 ± 6.0 vs. 8.5 ± 6.5 μg/L in women. p = not significant).
Conclusion: No clinically relevant sex-based differences were found in the TnI peaks after cardiac surgery.