Abstract 3937: C-Reactive Protein Predicts Acute Myocardial Infarction in High-Risk Noncardiac and Vascular Surgery
Background: High-sensitivity C-reactive protein (hsCRP) predicts cardiovascular events in a wide range of clinical contexts. However, the role of hsCRP as a predictive marker for perioperative acute myocardial infarction (AMI) in noncardiac surgery is not yet clear. The present study investigated hsCRP levels as predictors of AMI risk in patients undergoing high-risk noncardiac surgery.
Methods: This concurrent cohort study included patients aged ≥50 referred for high-risk noncardiac surgery according to AHA/ACC 2002 criteria. Patients with infections were excluded. Electrocardiograms (ECG) were performed and biomarkers (troponin I or T) and/or total creatine phosphokinase and the MB fraction (CPK-T/MB) were evaluated on the first and fourth days after surgery. Patients were followed until discharge. Baseline hsCRP levels were compared between patients with and without AMI.
Results: A total of 101 patients undergoing noncardiac surgery, including 33 vascular procedures (17 aortic and 16 peripheral artery revascularizations), were studied. Sixty of them were men, and mean age was 66 years. Baseline levels of hsCRP were higher in the group with perioperative AMI than in non-AMI patients (mean 48.02 vs 4.50, p=0.005). All five AMI cases occurred in vascular surgery patients with high CRP levels.
Conclusions: Patients undergoing high-risk noncardiac surgery presenting elevated baseline hsCRP levels are at increased risk for perioperative AMI. This finding may help to plan more effective screening strategies for AMI in high risk groups.