Dear Colleague,

I do not know the right answer, but I suggest to look at the following articles, cited by the ESC Guideline (Third universal definition ofmyocardial infarction 2012).

Best wishes,

79. Costa MA, Carere RG, Lichtenstein SV, Foley DP, de Valk V, Lindenboom W,

Roose PCH, van Geldorp TR, Macaya C, Castanon JL, Fernandez-Avile`z F,

Gonza´les JH, Heyer G, Unger F, Serruys PW. Incidence, predictors, and significance

of abnormal cardiac enzyme rise in patients treated with bypass surgery in

the arterial revascularization therapies study (ARTS). Circulation 2001;104:

2689–2693.

80. Klatte K, Chaitman BR, Theroux P, Gavard JA, Stocke K, Boyce S, Bartels C,

Keller B, Jessel A. Increased mortality after coronary artery bypass graft

surgery is associated with increased levels of postoperative creatine kinasemyocardial

band isoenzyme release. J Am Coll Cardiol 2001;38:1070–1077.

81. Brener SJ, Lytle BW, Schneider JP, Ellis SG, Topol EJ. Association between

CK-MB elevation after percutaneous or surgical revascularization and three-year

mortality. J Am Coll Cardiol 2002;40:1961–1967.

82. Domanski M, Mahaffey K, Hasselblad V, Brener SJ, Smith PK, Hillis G, Engoren M,

Alexander JH, Levy JH, Chaitman BR, Broderick S, Mack MJ, Pieper KS,

Farkouh ME. Association of myocardial enzyme elevation and survival following

coronary artery bypass graft surgery. JAMA 2011;305:585–589.

83. Croal BL, Hillis GS, Gibson PH, Fazal MT, El-Shafei H, Gibson G, Jeffrey RR,

Buchan KG, West D, Cuthbertson BH. Relationship between postoperative

cardiac troponin I levels and outcome of cardiac surgery. Circulation 2006;114:

1468–1475.

84. Selvanayagam JB, Petersen SE, Francis JM, Robson MD, Kardos A, Neubauer S,

Taggart DP. Effects of off-pump versus on-pump coronary surgery on reversible

and irreversible myocardial injury: a randomized trial using cardiovascular magnetic

resonance imaging and biochemical markers. Circulation 2004;109:

345–350.

Good resource as mentioned above. Generally 1 or 2 values mean nothing. They are supposed to be high after surgery, but an increasing trend with clinical condition can be more informative. Generally at our center in our practice we do not routinely measure it.