Limitations
The current study has several limitations. This study was retrospective
and observational in nature, and as such, may be subject to selection
bias. In order to account for such possible confounding and selection
bias, we did perform multivariable modeling to adjust for such
preoperative risk factors. However, it is possible that there may be
some unmeasured confounders that remain despite these measures.
Additionally, there is no specific protocol in which serial troponin
levels are drawn from patients presenting with acute coronary syndrome.
As such, collected troponin measurements may not always represent the
true “peak” troponin level, which may influence this study’s findings.
The timing of CABG in these patients was at the discretion of the
individual surgeon and was not standardized across patients.