Simultaneous measurement of cardiac troponin I, natriuretic peptide, and C-reactive protein for the prediction of long-term cardiac outcome after cardiac surgery
10.3760/cma.j.issn.1008-6706.2013.16.008
- VernacularTitle:肌钙蛋白、利尿钠肽和C反应蛋白对心脏手术远期疗效的预测价值
- Author:
Binchen LI
;
Chuzhong TANG
- Publication Type:Journal Article
- Keywords:
Troponin;
Natriuretic peptide;
C-reactive protein;
Heart operation;
Long-time outcome
- From:
Chinese Journal of Primary Medicine and Pharmacy
2013;20(16):2419-2422
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical value of simultaneous assessment of cardiac troponin I,Btype natriuretic peptide,and C-reactive protein in prediction of long-term cardiac outcome after cardiac surgery.Methods 224 patients undergoing cardiac surgery were included and followed up within 12 months after surgery.Serial blood samples were drawn in all patients the day before surgery,at the end of surgery,and 6,24,and 120h after surgery.Major adverse cardiac events within 12 months after surgery were chosen as study endpoints and were defined as malignant ventricular arrhythmia,myccardial infarction,congestive heart failure,the need for myocardial revascularization,and/or death from cardiac cause.Predictive ability of each cardiac biomarker was assessed using logistic regression.Results Accuracies of C-reactive protein,cardiac troponin I,and B-type natriuretic peptide,considered as continuous variables to predict the occurrence of major adverse cardiac events were limited(area under receiver operating characteristic curve:0..54[0.47 ～0.60],P =0.42,0.62[0.55 ～0,68],P =0.01,and 0.68[0.61 ～0.74],P ＜0,001,respectively).When biomarkers were considered as 75％ specificity dichotomized variables,evaluated C-reactive protein(＞ 180mg/L),cardiac troponin I(＞ 3.5ng/ml),and B-type natriuretic peptide (＞ 880pg/ml)were independent predictors of major adverse cardiac events(odds ratio:2.14[1.03 ～4.49],P =0.043,2.37 [1.25 ～ 5.64],P =0.011,and 2.65 [1.16 ～ 4.85],P =0.018,respectively) in a multivariate model including the European System for Cardiac Operative Risk Evaluation score.Conclusion Simultaneous measurement of cardiac troponin I,B-type natriuretic peptide,and C-reactive protein improves the risk assessment of long-term adverse cardiac outcome after cardiac surgery.
