C-Reactive protein predicts acute myocardial infarction during high-risk noncardiac and vascular surgery

BACKGROUND: High-sensitivity C-reactive protein predicts cardiovascular events in a wide range of clinical contexts. However, the role of high-sensitivity C-reactive protein as a predictive marker for perioperative acute myocardial infarction during noncardiac surgery is not yet clear. The present s...

Full description

Bibliographic Details
Main Authors: Oscar M. Martins, Vicente F. Fonseca, Ivan Borges, Vaierio Martins, Vera Lucia Portal, Lucia Campos Pellanda
Format: Article
Language:English
Published: Elsevier España 2011-01-01
Series:Clinics
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322011000500011
_version_ 1811329608145960960
author Oscar M. Martins
Vicente F. Fonseca
Ivan Borges
Vaierio Martins
Vera Lucia Portal
Lucia Campos Pellanda
author_facet Oscar M. Martins
Vicente F. Fonseca
Ivan Borges
Vaierio Martins
Vera Lucia Portal
Lucia Campos Pellanda
author_sort Oscar M. Martins
collection DOAJ
description BACKGROUND: High-sensitivity C-reactive protein predicts cardiovascular events in a wide range of clinical contexts. However, the role of high-sensitivity C-reactive protein as a predictive marker for perioperative acute myocardial infarction during noncardiac surgery is not yet clear. The present study investigated high-sensitivity C-reactive protein levels as predictors of acute myocardial infarction risk in patients undergoing high-risk noncardiac surgery. METHODS: This concurrent cohort study included patients aged >50 years referred for high-risk noncardiac surgery according to American Heart Association/ACC 2002 criteria. Patients with infections were excluded. Electrocardiograms were performed, and biomarkers (Troponin I or T) and/or total creatine phosphokinase and the MB fraction (CPK-T/MB) were evaluated on the first and fourth days after surgery. Patients were followed until discharge. Baseline high-sensitivity C-reactive protein levels were compared between patients with and without acute myocardial infarction. RESULTS: A total of 101 patients undergoing noncardiac surgery, including 33 vascular procedures (17 aortic and 16 peripheral artery revascularizations), were studied. Sixty of the patients were men, and their mean age was 66 years. Baseline levels of high-sensitivity C-reactive protein were higher in the group with perioperative acute myocardial infarction than in the group with non-acute myocardial infarction patients (mean 48.02 vs. 4.50, p = 0.005). All five acute myocardial infarction cases occurred in vascular surgery patients with high CRP levels. CONCLUSIONS: Patients undergoing high-risk noncardiac surgery, especially vascular surgery, and presenting elevated baseline high-sensitivity C-reactive protein levels are at increased risk for perioperative acute myocardial infarction.
first_indexed 2024-04-13T15:46:48Z
format Article
id doaj.art-b2e49ab3ec8d40e3bf220e2ece00afab
institution Directory Open Access Journal
issn 1807-5932
1980-5322
language English
last_indexed 2024-04-13T15:46:48Z
publishDate 2011-01-01
publisher Elsevier España
record_format Article
series Clinics
spelling doaj.art-b2e49ab3ec8d40e3bf220e2ece00afab2022-12-22T02:40:57ZengElsevier EspañaClinics1807-59321980-53222011-01-0166577377610.1590/S1807-59322011000500011C-Reactive protein predicts acute myocardial infarction during high-risk noncardiac and vascular surgeryOscar M. MartinsVicente F. FonsecaIvan BorgesVaierio MartinsVera Lucia PortalLucia Campos PellandaBACKGROUND: High-sensitivity C-reactive protein predicts cardiovascular events in a wide range of clinical contexts. However, the role of high-sensitivity C-reactive protein as a predictive marker for perioperative acute myocardial infarction during noncardiac surgery is not yet clear. The present study investigated high-sensitivity C-reactive protein levels as predictors of acute myocardial infarction risk in patients undergoing high-risk noncardiac surgery. METHODS: This concurrent cohort study included patients aged >50 years referred for high-risk noncardiac surgery according to American Heart Association/ACC 2002 criteria. Patients with infections were excluded. Electrocardiograms were performed, and biomarkers (Troponin I or T) and/or total creatine phosphokinase and the MB fraction (CPK-T/MB) were evaluated on the first and fourth days after surgery. Patients were followed until discharge. Baseline high-sensitivity C-reactive protein levels were compared between patients with and without acute myocardial infarction. RESULTS: A total of 101 patients undergoing noncardiac surgery, including 33 vascular procedures (17 aortic and 16 peripheral artery revascularizations), were studied. Sixty of the patients were men, and their mean age was 66 years. Baseline levels of high-sensitivity C-reactive protein were higher in the group with perioperative acute myocardial infarction than in the group with non-acute myocardial infarction patients (mean 48.02 vs. 4.50, p = 0.005). All five acute myocardial infarction cases occurred in vascular surgery patients with high CRP levels. CONCLUSIONS: Patients undergoing high-risk noncardiac surgery, especially vascular surgery, and presenting elevated baseline high-sensitivity C-reactive protein levels are at increased risk for perioperative acute myocardial infarction.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322011000500011C-reactive proteinNoncardiac surgeryCardiac risk in noncardiac surgeryPerioperative eventsCardiovascular disease
spellingShingle Oscar M. Martins
Vicente F. Fonseca
Ivan Borges
Vaierio Martins
Vera Lucia Portal
Lucia Campos Pellanda
C-Reactive protein predicts acute myocardial infarction during high-risk noncardiac and vascular surgery
Clinics
C-reactive protein
Noncardiac surgery
Cardiac risk in noncardiac surgery
Perioperative events
Cardiovascular disease
title C-Reactive protein predicts acute myocardial infarction during high-risk noncardiac and vascular surgery
title_full C-Reactive protein predicts acute myocardial infarction during high-risk noncardiac and vascular surgery
title_fullStr C-Reactive protein predicts acute myocardial infarction during high-risk noncardiac and vascular surgery
title_full_unstemmed C-Reactive protein predicts acute myocardial infarction during high-risk noncardiac and vascular surgery
title_short C-Reactive protein predicts acute myocardial infarction during high-risk noncardiac and vascular surgery
title_sort c reactive protein predicts acute myocardial infarction during high risk noncardiac and vascular surgery
topic C-reactive protein
Noncardiac surgery
Cardiac risk in noncardiac surgery
Perioperative events
Cardiovascular disease
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322011000500011
work_keys_str_mv AT oscarmmartins creactiveproteinpredictsacutemyocardialinfarctionduringhighrisknoncardiacandvascularsurgery
AT vicenteffonseca creactiveproteinpredictsacutemyocardialinfarctionduringhighrisknoncardiacandvascularsurgery
AT ivanborges creactiveproteinpredictsacutemyocardialinfarctionduringhighrisknoncardiacandvascularsurgery
AT vaieriomartins creactiveproteinpredictsacutemyocardialinfarctionduringhighrisknoncardiacandvascularsurgery
AT veraluciaportal creactiveproteinpredictsacutemyocardialinfarctionduringhighrisknoncardiacandvascularsurgery
AT luciacampospellanda creactiveproteinpredictsacutemyocardialinfarctionduringhighrisknoncardiacandvascularsurgery