Related Experiment Video
Updated: May 13, 2026
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Preoperative C-reactive protein can predict early clinical outcomes following elective off-pump CABG surgery in
Seyed Jalil Mirhosseini1, Seyed Khalil Forouzannia, Sadegh Ali-Hassan-Sayegh
1Department of Cardiac Surgery, Yazd Cardiovascular Research Center, Yazd, Iran.
Insights
Preoperative high-sensitivity C-reactive protein (hsCRP) levels predict atrial fibrillation (AF) and complications after coronary artery bypass graft (CABG) surgery in patients with severe left ventricular dysfunction. Elevated hsCRP indicates higher risk for these adverse events.
Area of Science:
- Cardiology
- Biomarkers
- Surgical Outcomes
Background:
- Atrial fibrillation (AF) is a common arrhythmia post-coronary artery bypass graft (CABG) surgery.
- Postoperative AF and complications can lead to long-term morbidity and mortality.
- High-sensitivity C-reactive protein (hsCRP) is linked to cardiovascular disorders.
Purpose of the Study:
- To assess if preoperative hsCRP (≥3 mg/dl) predicts postoperative AF.
- To evaluate if preoperative hsCRP predicts early complications after elective off-pump CABG.
- Focus on patients with severe left ventricle dysfunction (Ejection Fraction <30%).
Main Methods:
- 104 patients with severe left ventricular dysfunction undergoing elective off-pump CABG were studied.
- Patients were divided into two groups based on preoperative hsCRP levels (≥3 mg/dl vs. <3 mg/dl).
- Postoperative outcomes including AF, early morbidity, ICU/hospital stay, and mortality were evaluated.
Main Results:
- Postoperative AF occurred in 33.3% of patients with hsCRP ≥3 mg/dl versus 3.8% with hsCRP <3 mg/dl (P=0.03).
- Midsternotomy infection, respiratory dysfunction, and hospital stay were significantly higher in the elevated hsCRP group.
- No significant differences were found for bleeding, vomiting, renal dysfunction, or ICU stay between groups.
Conclusions:
- Preoperative hsCRP ≥3 mg/dl is a predictor of postoperative AF after off-pump CABG.
- Elevated preoperative hsCRP also predicts complications like midsternotomy infection and respiratory dysfunction.
- These findings highlight hsCRP as a valuable preoperative risk marker in this patient population.
Purpose:
Atrial fibrillation (AF) is the most common type of arrhythmia following elective off-pump coronary bypass graft (CABG) surgery, occurring on the 2(nd) or 3(rd) postoperative day. Postoperative atrial fibrillation and early complications may be the cause of long term morbidity and mortality after hospital discharge. High sensitive C-reactive protein (hsCRP) seems to be most significantly associated with cardiovascular disorders. This study was designed to evaluate whether preoperative hsCRP (≥3 mg/dl) can predict post-elective off-pump CABG, AF, and early complications in patients with severe left ventricle dysfunction (Ejection Fraction (EF)<30%).
Methods:
This study was conducted on 104 patients with severe left ventriclar dysfunction (EF < 30%), undergoing elective off-pump CABG surgery during April to September 2011 at the Afshar Cardiovascular Center in Yazd, Iran. Patients undergoing emergency surgery and those with unstable angina, creatinine higher than 2.0 mg/dl, malignancy, or immunosuppressive disease were excluded from the study. The subjects were divided into two groups: Group I with preoperative increased hsCRP (>3 mg/dl) (n=51) and group N with preoperative normal hsCRP (<3 mg/dl) (n=53). We evaluated post-CABG variables including incidence, duration, and frequency of AF, early morbidity (bleeding, infection, vomiting, renal and respiratory dysfunctions), ICU or hospital stay and early mortality. Data were then analyzed by Analysis of Variance (ANOVA), Chi-square and Fisher exact test for quantitative and qualitative variables.
Results:
The average age of the patients was 62.5 years, 75 cases (72.1%) were male, and 39 (37.5%) were female. Postoperative AF occurred in 19 cases (18.2%); 17 cases (33.3%) had hsCRP≥3 mg/dl and 2 cases (3.8%) had hsCRP≤3 mg/dl (P=0.03). Postoperative midsternotomy infection, respiratory dysfunction, and hospital stay were significantly higher in group I compared with group N (P<0.05). No statistical significant differences were identified between the two groups concerning other postoperative complications (bleeding, vomiting, renal dysfunction and ICU stay) (P>0.05).
Conclusion:
Preoperative hsCRP ≥3 mg/dl can predict incidence of postoperative atrial fibrillation and early complications such as midsternotomy infection, respiratory dysfunction, and hospital stay following elective off-pump CABG.
Related Concept Videos
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...