title: Preoperative HO-1 levels as prognostic factor for adverse cardiac events in elder patients undergoing non-cardiac surgery.
abstract: BACKGROUND
  Hypoxia-inducible factor-1α (HIF-1α) and heme oxygenase-1(HO-1) are involved in the tissue hypoxic response.
  
  
  OBJECTIVE
  HIF-1α and HO-1 levels may predict cardiac ischemia and adverse cardiac events during non-cardiac surgery.
  
  
  METHODS
  HIF-1α and HO-1 levels were determined in elderly patients undergoing non-cardiac surgery preoperatively and at 30 minutes, 48 and 72 hours postoperatively. Results were analyzed with respect to the occurrence of adverse cardiac events.
  
  
  RESULTS
  A total of 380 patients with a mean age of 65.3 years were included, and 54 (14.2%) who had adverse cardiac events during or after the surgery. HIF-1α and HO-1 levels in the adverse cardiac event group were significantly higher than in the group without adverse cardiac events at each time point (all, P<0.05). In multivariates regression analysis, the odds of an adverse cardiac event was increased by every 1-year increase in age (odd ratio [OR] 1.39, P<0.001), abnormal ECG at baseline (OR 2.27, P = 0.048), myocardial infarction history (OR 3.18, P = 0.015), and positive baseline cTnI level were associated with an increased likelihood of an adverse cardiac event (OR 8.78, P = 0.019), and for every 1 unit increase of HO-1, the odds of an adverse cardiac event increased by 1.30 (P = 0.002).
  
  
  CONCLUSIONS
  Determination of preoperative HO-1 levels may aid in identifying patients at risk of developing ischemic cardiac events.
authors.affiliation: Department of Anesthesiology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zheng
authors.forename: Hai-Ping
authors.initials: HP
authors.lastname: Ma
authors.forename: Jiang
authors.initials: J
authors.lastname: Wang
authors.forename: Ming
authors.initials: M
authors.lastname: Ma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000097:blood / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D005260:Female; D006331:Heart Diseases / Q000097:blood* / Q000209:etiology*; D006333:Heart Failure / Q000097:blood / Q000209:etiology; D051547:Heme Oxygenase-1 / Q000097:blood*; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology; D017202:Myocardial Ischemia / Q000097:blood / Q000209:etiology; D059035:Perioperative Period; D011183:Postoperative Complications / Q000097:blood* / Q000209:etiology*; D011184:Postoperative Period; D011379:Prognosis; D012307:Risk Factors; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D019210:Troponin I; C496541:HMOX1 protein, human; D051547:Heme Oxygenase-1