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Published on: January 28, 2020

Pre-operative high sensitive C-reactive protein predicts cardiovascular events after coronary artery bypass grafting

Mindaugas Balciunas1, Loreta Bagdonaite, Robertas Samalavicius

  • 1Department of Pathology, Forensic Medicine and Pharmacology, Vilnius University Faculty of Medicine, Vilnius, Lithuania. mindaugas.balciunas@santa.lt

Annals of Cardiac Anaesthesia
|July 16, 2009
PubMed

Insights

Pre-operative high-sensitivity C-reactive protein (hs-CRP) levels predict cardiovascular events after coronary artery bypass grafting (CABG). Elevated hs-CRP (≥ 3.3 mg/l) significantly increases the risk of post-CABG complications.

Area of Science:

  • Cardiology
  • Biomarkers
  • Surgical Outcomes

Background:

  • C-reactive protein (CRP) is a known predictor of cardiovascular events.
  • The association between CRP and in-hospital outcomes following coronary artery bypass grafting (CABG) remains unclear.
  • This study investigates the predictive value of pre-operative CRP for cardiovascular events post-CABG.

Purpose of the Study:

  • To evaluate the predictive capability of pre-operative high-sensitivity C-reactive protein (hs-CRP) for in-hospital cardiovascular events after CABG surgery.
  • To establish a potential cut-off value for hs-CRP to identify high-risk patients.
  • To identify independent predictors of cardiovascular events post-CABG.

Main Methods:

  • hs-CRP levels were measured pre-operatively in 66 patients undergoing elective on-pump CABG.
  • Post-operative cardiovascular events, including death, stroke, myocardial damage, myocardial infarction, and low output heart failure, were recorded within 30 days.
  • Receiver Operating Characteristic (ROC) analysis was used to determine the hs-CRP cut-off point.

Main Results:

  • 14 out of 66 patients (21%) experienced post-operative cardiovascular events.
  • An hs-CRP concentration ≥ 3.3 mg/l was associated with a significantly higher risk of post-operative cardiovascular events (36% vs. 6%, P=0.01).
  • Independent predictors of combined cardiovascular events included hs-CRP ≥ 3.3 mg/l, intra-operative red blood cell transfusion, and absence of diuretics in antihypertensive treatment.

Conclusions:

  • Pre-operative hs-CRP levels are a powerful independent predictor of in-hospital cardiovascular events after on-pump CABG.
  • An hs-CRP cut-off of 3.3 mg/l can identify patients at increased risk for post-operative cardiovascular complications.
  • hs-CRP measurement offers valuable prognostic information for patients undergoing CABG surgery.

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