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 (Journal article)

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

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.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: 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
URI: https://olympias.lib.uoi.gr/jspui/handle/123456789/19186
ISSN: 1473-5830
Link: http://www.ncbi.nlm.nih.gov/pubmed/21730823
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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