Postoperative levels of cardiac troponin versus CK-MB and high-sensitivity C-reactive protein for the prediction of 1-year cardiovascular outcome in patients undergoing vascular surgery

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Μικρογραφία εικόνας

Ημερομηνία

Συγγραφείς

Kouvelos, G. N.
Milionis, H. J.
Arnaoutoglou, E. M.
Chasiotis, G.
Gartzonika, C.
Papa, N. K.
Tzimas, P.
Matsagkas, M. I.

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Εκδότης

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Είδος δημοσίευσης σε συνέδριο

Είδος περιοδικού

peer-reviewed

Είδος εκπαιδευτικού υλικού

Όνομα συνεδρίου

Όνομα περιοδικού

Coron Artery Dis

Όνομα βιβλίου

Σειρά βιβλίου

Έκδοση βιβλίου

Συμπληρωματικός/δευτερεύων τίτλος

Περιγραφή

OBJECTIVE: This study evaluated comparatively the predictive value of postoperative cardiac troponin I (cTnI), creatinine kinase (CK)-MB, and high-sensitivity C-reactive protein (hs-CRP) in 1-year cardiovascular mortality and morbidity in patients undergoing elective vascular surgery. METHODS: A total of 295 consecutive patients undergoing elective noncardiac vascular surgery were prospectively followed-up over a period of 12 months. The levels of cTnI, CK-MB, and hs-CRP were measured preoperatively and 24 h after operation. The primary endpoint was the composite of cardiovascular death, nonfatal acute myocardial infarction, ischemic stroke, and unstable angina. RESULTS: The primary endpoints occurred in 11 patients (3.8%). Receiver operating characteristic curve analysis showed that postoperative cTnI was a strong predictor of a cardiovascular event during 1-year follow-up (area under the curve, 0.852; P<0.001). Areas under the curve for hs-CRP and for CK-MB were 0.734 (P=0.008) and 0.494 (P=0.947). A threshold cTnI value of 0.4 ng/ml was highly associated with the occurrence of a cardiovascular event, with a sensitivity of 80% and specificity of 81%. Furthermore, cTnI levels provided a significantly better prediction than CK-MB levels (P=0.009) and tended to be superior to hs-CRP (P=0.2). CONCLUSION: Postoperative cTnI levels seem to be superior to CK-MB and hs-CRP levels for the prediction of 1-year cardiovascular mortality and morbidity in patients undergoing elective vascular surgery.

Περιγραφή

Λέξεις-κλειδιά

Adult, Aged, Aged, 80 and over, Biological Markers/blood, C-Reactive Protein/*analysis, Cardiovascular Diseases/blood/diagnosis/etiology/mortality, Chi-Square Distribution, Creatine Kinase, MB Form/*blood, Disease-Free Survival, Female, Greece, Humans, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, ROC Curve, Risk Assessment, Risk Factors, Sensitivity and Specificity, Surgical Procedures, Elective, Time Factors, Treatment Outcome, Troponin I/*blood, Vascular Surgical Procedures/*adverse effects/mortality

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Σύνδεσμος

http://www.ncbi.nlm.nih.gov/pubmed/21730823

Γλώσσα

en

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Εξεταστική επιτροπή

Γενική Περιγραφή / Σχόλια

Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος

Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής

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