title: [Prognostic role of new biomarkers in off-pump coronary artery bypass surgery].
abstract: The value of biomarkers of myocardial damage or inflammation in off-pump coronary artery bypass (OPCAB) surgery has not yet been established. In a prospective study of 51 consecutive patients scheduled for elective OPCAB surgery, preoperative levels of troponin T, C-reactive protein, interleukin-6 and tumor necrosis factor-alpha were determined. The primary endpoint was the combination of cardiac death or acute myocardial infarction (AMI) within 30 days. Seven patients (14%) presented with an adverse event: three cardiac deaths and six AMIs. Univariate analysis identified the following adverse event predictors: renal failure (50% vs 11%, P=.028), left ventricular ejection fraction 0.10 ng/dL (43% vs 9%, P=.016), and EuroSCORE rating (7.6 [2.5] VS. 5.2 [2.6], P=.031). A preoperative troponin-T level > 0.10 ng/dL (P=.03) was the only independent adverse event predictor. No significant differences were found with biomarkers of inflammation (P.05). The presence of a preoperative troponin-T level > 0.10 ng/dL is associated with a higher risk of cardiac death or AMI in patients undergoing OPCAB surgery.
authors.affiliation: Servicio de Cirugía Cardiovascular, Hospital Universitario Virgen de La Arrixaca, Murcia, España. arribasdelpeso@telepolis.com
authors.forename: José M
authors.initials: JM
authors.lastname: Arribas-Leal
authors.forename: Domingo A
authors.initials: DA
authors.lastname: Pascual-Figal
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Tornel-Osorio
authors.forename: Juan A
authors.initials: JA
authors.lastname: Ruipérez-Abizanda
authors.forename: Mariano
authors.initials: M
authors.lastname: Valdés-Chavarri
authors.forename: Ramón
authors.initials: R
authors.lastname: Arcas-Meca
mesh_terms: D000368:Aged; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis*; D047549:Coronary Artery Bypass, Off-Pump; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000209:etiology; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D020107:Troponin T / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D020107:Troponin T; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein