Comparing cardiac troponin levels using sevoflurane and isoflurane in patients undergoing cardiac surgery: a systematic review and metaanalysis

Cardiac troponin is one of the heart biomarkers,its high levels correlates with ahigh risk of cardiomyocytes damage. This study aimed to compare sevoflurane,isoflurane effect ontroponin levels in patients undergoing cardiac surgery.

We systematically searched for RCTs which had been published in Cochrane library,PubMed,Web of science,CRD,Scopus,and Google Scholar by the end of February 30th,2019. The quality ofarticles was evaluated with the Cochrane checklist. GRADE was used for quality of evidence for thismeta-analysis. Meta-analysis was done based on random or fixed effect model.

Five studies with total of 190 (sevoflurane),191 (isoflurane) patients were included. Theresults showed that pooled mean difference of troponin levels between the two groups was significantat ICU admission time,24 hours after entering. The comparison of troponin level changes betweenthe two groups (baseline,at time ICU) in 24,48 hours after ICU admission was significant.

This meta-analysis showed that blood troponin levels were significantly lower at the timeof arrival in ICU with isoflurane,after 24 hours with sevoflurane. Generally,given the small meandifference between isoflurane,sevoflurane,it seems that none of the medications has a negativeeffect on the cardiac troponin level.