[Prognostic role of new biomarkers in off-pump coronary artery bypass surgery].
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.
Arribas-Leal
José M
JM
Servicio de Cirugía Cardiovascular, Hospital Universitario Virgen de La Arrixaca, Murcia, España. arribasdelpeso@telepolis.com
Pascual-Figal
Domingo A
DA
Tornel-Osorio
Pedro L
PL
Ruipérez-Abizanda
Juan A
JA
Valdés-Chavarri
Mariano
M
Arcas-Meca
Ramón
R
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
D015415:Biomarkers; D015850:Interleukin-6; D020107:Troponin T; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein