Predictors of long-term mortality and cardiac events in patients with known or suspected coronary artery disease who survive major non-cardiac surgery.
The aim of this prospective study was to assess predictors of long-term outcome in patients with documented or suspected coronary artery disease who survive major non-cardiac surgery. The impact of patients' comorbidities, pre-operative heart rate variability and postoperative increase in cardiac troponin I on all-cause mortality and major cardiac events within 2 years was explored using multivariable logistic regression. Six of 173 patients died within the first month after surgery and were excluded from the study. Thirty-four of 167 patients (20%) died 1-24 months after surgery. Independent predictors of all-cause mortality were history of congestive heart failure (odds ratio 6.4 [95%, confidence interval 1.7-24]), pre-operatively depressed heart rate variability (odds ratio 6.4 [95%, confidence interval 1.9-21]), and age > 70 years (odds ratio 4.5 [95%, confidence interval 1.2-16]). In contrast, postoperative elevation of cardiac troponin I did not independently predict all-cause mortality or major cardiac events.
Filipovic
M
M
Department of Anaesthesia, University Hospital Basel, CH 4031 Basel, Switzerland. mfilipovic@uhbs.ch
Jeger
R V
RV
Girard
T
T
Probst
C
C
Pfisterer
M
M
Gürke
L
L
Studer
W
W
Seeberger
M D
MD
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002423:Cause of Death; D003327:Coronary Disease / Q000150:complications*; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006333:Heart Failure / Q000150:complications; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000401:mortality; D016019:Survival Analysis; D019210:Troponin I / Q000378:metabolism
D015415:Biomarkers; D019210:Troponin I