title: Preoperative C-reactive protein levels to predict early and late mortalities after coronary artery bypass surgery: eight years of follow-up.
abstract: OBJECTIVE
  There is limited evidence that increased preoperative levels of C-reactive protein are associated with increased mortality after coronary artery bypass grafting. We retrospectively investigated in 5669 patients the predictive value of preoperative C-reactive protein levels for early and late mortalities after coronary artery bypass grafting.
  
  
  METHODS
  Patients undergoing isolated coronary artery bypass grafting between January 2000 and December 2007 (n = 8500) were studied. Preoperative demographic data and risk factors and outcome data (mortality data) were prospectively collected in a database. Preoperative C-reactive protein levels were retrieved from the laboratory data.
  
  
  RESULTS
  In 5669 of 8500 cases, the preoperative C-reactive protein level could be retrieved. Seventy-five patients were unavailable for follow-up. A preoperative C-reactive protein level greater than 10 mg/L was an independent risk factor for early mortality, whereas a level greater than 5 mg/L was a risk factor for late mortality. Other risk factors were age, sex, chronic obstructive pulmonary disease, diabetes, left ventricular ejection fraction less than 35%, peripheral vascular disease, and previous cardiac surgery. We found a higher mean C-reactive protein value in patients with a left ventricular ejection fraction less than 35% (18.5 +/- 33 mg/L) than in those with an ejection fraction greater than 35% (P < .0001).
  
  
  CONCLUSIONS
  Preoperative C-reactive protein levels can be used in risk stratification in coronary artery bypass grafting surgery. A C-reactive protein level greater than 10 mg/L is a risk factor for early mortality, whereas a level greater than 5 mg/L is a risk factor for late mortality.
authors: Department of Cardio-Thoracic Surgery, Catharina Hospital-Brabant Medical School, Eindhoven, The Netherlands.
authors: Albert H M
authors: AH
authors: van Straten
authors: Mohamed A
authors: MA
authors: Soliman Hamad
authors: André J
authors: AJ
authors: van Zundert
authors: Elisabeth J
authors: EJ
authors: Martens
authors: Jacques P A M
authors: JP
authors: Schönberger
authors: Andre M
authors: AM
authors: de Wolf
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D001026:Coronary Artery Bypass / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume
chemical_list: D002097:C-Reactive Protein