The following is a summary of “Troponin T and N-terminal pro-brain natriuretic peptide are associated with long-term all-cause mortality in patients with post-sternotomy mediastinitis following coronary artery bypass grafting: A 15-year follow-up study,” published in the August 2023 issue of Cardiology by Risnes et al. 

Deep sternal wound infection (DSWI) after coronary artery bypass grafting (CABG) is rare but can increase the risk of cardiac death and IMA graft obstruction. The exact mechanism is unknown. 

Researchers performed a retrospective study to investigate the association between DSWI and all-cause mortality in patients who have undergone CABG. The study also aimed to determine whether the association was driven by cardiac-specific biomarkers, such as N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin T(TnT).

The study included 82 CABG patients (41 with mediastinitis) and offered the most extensive, longest follow-up data. The incidence rate of mediastinitis remained stable at 0.14% per year throughout. Over a mean 12.7±3.5 years follow-up, 42 deaths occurred (65.9% in the mediastinitis group and 36.6% in the non-mediastinitis group, P=0.008). Deceased patients were characterized by older age, lower eGFR, a higher prevalence of atrial fibrillation, and elevated systolic BP compared to those who remained alive.

These findings suggested post-CABG mediastinitis linked to worse 15-year outcomes, with nearly double mortality vs. non-mediastinitis. The difference was seen mostly after 10 years. Connection to mortality influenced by subclinical heart damage indicated by higher TnT, NT-proBNP 2.7 years later, highlighting their prognostic value in CABG patients.

Source: pubmed.ncbi.nlm.nih.gov/37586344/