Predictive Value of C-Reactive Protein for Major Postoperative Complications Following Off-Pump Coronary Artery Bypass Surgery Prospective and Observational Trial

Abstract

Background: To prospectively investigate the predictive value of the preoperative C-reactive protein (CRP) concentration for major postoperative complications following off-pump coronary artery bypass (OPCAB) surgery. Methods and Results: From January 2007 to December 2007, 185 consecutive patients scheduled for elective OPCAB surgery were allocated to a low-CRP group (n=137, CRP <0.3 mg/dl) and a high-CRP group (n=48, CRP ≥0.3 mg/dl). The incidence of major postoperative complications, defined as postoperative myocardial infarction, and 5 major morbidity endpoints including permanent stroke, renal dysfunction, any cardiac surgery reoperation, ventilation for more than 48 h, and deep sternal wound infection were assessed and compared. Multivariate logistic regression was used to determine the predictors of major postoperative complications. Patients in the high-CRP group had a significantly higher overall incidence of major postoperative complications, particularly renal dysfunction. In the multivariate logistic regression model, adjusting all the significant univariate predictors, baseline CRP >0.3 mg/dl and preoperative chronic renal failure (CRF) remained as significant independent predictors of major postoperative complications. Conclusions: Elevated preoperative CRP level and/or preoperative CRF indicate increased risk of developing major postoperative complications, particularly acute postoperative renal dysfunction in patients undergoing OPCAB surgery. (Circ J 2009; 73: 872 -877)

Renal Dysfunction on Admission, Worsening Renal Function, and Severity of Acute Kidney Injury Predict 2-Year Mortality in Patients With Acute Myocardial Infarction

“…[25][26][27][28][29][30][31] In addition, these clinical variables also have been proved to be AKI predictors in cardiovascular patients. [32][33][34][35][36] In the present study, by adjusting the baseline risk factors, inflammatory markers, severity of AMI and treatment in the multivariate analysis, initial eGFR and hs-CRP level on admission were independent predictors for AKI occurrence during the first week of an AMI patient's hospitalization. This finding agrees with previous studies and prompts clinicians to pay more attention to those patients with initial renal dysfunction and greater inflammatory status in order to avoid further kidney injury.…”

Does decreased mean platelet volume predict inflammation in chronic renal failure, dialysis, and transplanted patients?

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Early Detection and Prediction by Biomarkers of Acute Kidney Injury After Cardiac Surgery

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