RML and high cardiac markers:
One interesting observation from the study was that despite using a higher cut off value for CK to define RML (to account for the myocardial injury associated with cardiac surgery); we observed a significantly higher value of troponin in the RML group. This was not associated with other signs of myocardial damage as evidenced by an insignificant difference in inotropic requirements (Table 2). This difference could be explained by the fact that in RML, cardiac enzymes may be elevated unrelated to the degree of muscle damage23.24,.25. Yet another explanation could be the higher incidence of AKI in the RML group. AKI is known to be associated with delayed clearance of troponins as reported in the previous study from our center26.