Usefulness of preoperative C-reactive protein and soluble intercellular adhesion molecule-1 level for predicting future cardiovascular events after coronary artery bypass grafting.
High levels of C-reactive protein and soluble intercellular adhesion molecule-1 are associated with increased risk for cardiovascular events. No long-term data are available on predictive value of preoperative levels of C-reactive protein and soluble intercellular adhesion molecule-1 on outcome after coronary artery bypass grafting. We measured baseline levels of C-reactive protein and soluble intercellular adhesion molecule-1 in preoperative serum stored at -80 degrees C in 87 patients with coronary artery disease before undergoing isolated coronary artery bypass grafting. Follow-up was performed after a mean duration of 7.6+/-0.1 years, and all cardiovascular events were recorded. Data were analyzed by categorizing patients into 2 groups according to median value of C-reactive protein and soluble intercellular adhesion molecule-1. During follow-up, 16 patients developed a cardiovascular event. In patients with C-reactive protein above the median (1.9 mg/L), the cumulative cardiovascular event incidence was 29% compared with 9% in patients with levels below the median (p=0.048). In Cox regression analysis that was corrected for age, gender, and conventional risk factors, the adjusted relative risk of cardiovascular events of C-reactive protein above the median was 3.9 (95% confidence interval 1.1 to 13.9, p <0.05). Soluble intercellular adhesion molecule-1 level above the median (136 microg/L) was associated with a cumulative cardiovascular event incidence of 21% versus 16% below the median (p=0.48). In conclusion, in patients who undergo coronary artery bypass grafting, high preoperative levels of C-reactive protein levels, but not of soluble intercellular adhesion molecule-1, were associated with long-term risk of cardiovascular events, independent of other cardiac risk factors.
van der Harst
Pim
P
Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. p.van.der.harst@thorax.umcg.nl
Voors
Adriaan A
AA
Volbeda
Meint
M
Buikema
Hendrik
H
van Veldhuisen
Dirk J
DJ
van Gilst
Wiek H
WH
D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000097:blood / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality; D011183:Postoperative Complications / Q000097:blood*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012044:Regression Analysis; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000097:blood; D020521:Stroke / Q000097:blood
D015415:Biomarkers; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein