Preoperative C-reactive protein levels to predict early and late mortalities after coronary bypass surgery:Eight years of follow up

Van Staten, Albert H., Soliman Hamad, Mohamed A., van Zundert, Andre J., Martens, Elisabeth J., Schonberger, Jacques P.A. M. and de Wolf, Andre M. (2009) Preoperative C-reactive protein levels to predict early and late mortalities after coronary bypass surgery:Eight years of follow up. Journal of Thoracic and Cardiovascular Surgery, 138 4: 954-958. doi:10.1016/j.jtcvs.2009.03.050


Author Van Staten, Albert H.
Soliman Hamad, Mohamed A.
van Zundert, Andre J.
Martens, Elisabeth J.
Schonberger, Jacques P.A. M.
de Wolf, Andre M.
Title Preoperative C-reactive protein levels to predict early and late mortalities after coronary bypass surgery:Eight years of follow up
Journal name Journal of Thoracic and Cardiovascular Surgery   Check publisher's open access policy
ISSN 0022-5223
1097-685X
Publication date 2009-01-01
Year available 2009
Sub-type Article (original research)
DOI 10.1016/j.jtcvs.2009.03.050
Volume 138
Issue 4
Start page 954
End page 958
Total pages 5
Place of publication Philadelphia, PA United States
Publisher Mosby
Language eng
Formatted abstract
Objective
There is limited evidence that increased preoperative levels of C-reactive protein are associated with increased mortality after coronary artery bypass grafting. We retrospectively investigated in 5669 patients the predictive value of preoperative C-reactive protein levels for early and late mortalities after coronary artery bypass grafting.

Methods
Patients undergoing isolated coronary artery bypass grafting between January 2000 and December 2007 (n = 8500) were studied. Preoperative demographic data and risk factors and outcome data (mortality data) were prospectively collected in a database. Preoperative C-reactive protein levels were retrieved from the laboratory data.

Results
In 5669 of 8500 cases, the preoperative C-reactive protein level could be retrieved. Seventy-five patients were unavailable for follow-up. A preoperative C-reactive protein level greater than 10 mg/L was an independent risk factor for early mortality, whereas a level greater than 5 mg/L was a risk factor for late mortality. Other risk factors were age, sex, chronic obstructive pulmonary disease, diabetes, left ventricular ejection fraction less than 35%, peripheral vascular disease, and previous cardiac surgery. We found a higher mean C-reactive protein value in patients with a left ventricular ejection fraction less than 35% (18.5 ± 33 mg/L) than in those with an ejection fraction greater than 35% (P < .0001).

Conclusions
Preoperative C-reactive protein levels can be used in risk stratification in coronary artery bypass grafting surgery. A C-reactive protein level greater than 10 mg/L is a risk factor for early mortality, whereas a level greater than 5 mg/L is a risk factor for late mortality.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Thu, 21 May 2015, 01:42:09 EST by Andre Van Zundert on behalf of Anaesthesiology and Critical Care - RBWH