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Cardiac Biomarkers Predicting MACE in Patients Undergoing Noncardiac Surgery: A Meta-Analysis

Li-Jun Zhang1, Na Li1, Yang Li2,3

  • 1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Frontiers in Physiology
|February 5, 2019
PubMed

Insights

Elevated levels of brain natriuretic peptide (BNP), cardiac troponin (cTn), and high-sensitivity C-reactive protein (hs-CRP) significantly predict major adverse cardiovascular events (MACE) after noncardiac surgery. These biomarkers indicate a substantially increased risk for patients.

Area of Science:

  • Cardiology
  • Biomarker Research
  • Surgical Risk Assessment

Background:

  • Noncardiac surgery poses cardiovascular risks.
  • Predictive biomarkers for postoperative major adverse cardiovascular events (MACE) are crucial.
  • Brain natriuretic peptide (BNP), cardiac troponin (cTn), and C-reactive protein (CRP) are potential indicators.

Purpose of the Study:

  • To systematically evaluate the predictive effectiveness and accuracy of BNP, cTn, and hs-CRP for MACE in noncardiac surgery patients.
  • To synthesize evidence from existing studies on these biomarkers' association with adverse cardiovascular outcomes.

Main Methods:

  • A meta-analysis of 26 studies involving 7,877 participants.
  • Data systematically collected from PubMed, Embase, CNKI, CQVIP, and Wanfang databases.
  • Statistical analysis performed using Review Manager 5.3 and Stata/SE 12 software.

Main Results:

  • Elevated BNP/NT-proBNP, cTnI/cTnT, and hs-CRP were strongly associated with increased MACE risk.
  • BNP/NT-proBNP elevation increased MACE risk by approximately 4-fold (RR: 3.92).
  • cTnI/cTnT elevation was linked to nearly a 5-fold higher MACE risk (RR: 5.52).
  • hs-CRP elevation was associated with a nearly 4-fold higher MACE risk (RR: 3.73).

Conclusions:

  • BNP/NT-proBNP, cTnI/cTnT, and hs-CRP elevations predict a significantly higher risk of postoperative MACE.
  • These biomarkers are valuable tools for risk stratification in patients undergoing noncardiac surgery.
  • Pre- or immediate post-operative assessment of these biomarkers can aid in identifying high-risk individuals.

Keywords:
acute coronary syndromescardiac biomarkerscardiac risk factors and preventionmeta-analysisnoncardiac surgery

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