Boston, MA – C-reactive protein (CRP), a marker of systemic inflammation routinely measured in patients to assess their risk for heart attack, has recently emerged as a predictor of adverse cardiac events in healthy people. Now researchers at Brigham and Women’s Hospital (BWH) and colleagues have also demonstrated that elevated levels of CRP may increase the length of hospital stay and risk of death for patients who have undergone coronary artery bypass surgery. The findings appear in the March issue of Anesthesiology.
In this new study, research on CRP levels has been extended to the cardiac surgical population; investigating CRP levels as additional predictors for adverse events and increased mortality in otherwise healthy patients undergoing coronary artery bypass surgery.
“Based on previous research, we knew that patients who present for CABG surgery with high levels of circulating CRP are at risk for increased adverse outcomes, including extended hospital stays and elevated mortality rates, compared to patients with normal or very low CRP levels. These risks are increased if high CRP levels are associated with ongoing myocardial ischemia or infarction,”
The researchers studied 914 patients undergoing routine, non-emergency CABG surgery to determine whether circulating preoperative CRP levels in patients could help predict hospital length of stay and long-term postoperative survival.
Patients were stratified to four categories based on preoperative CRP levels; 10 mg/L. Excluding patients with increased CRP levels due to infections, autoimmune disease or ongoing myocardial ischemia or infarction, researchers examined the association between the stratified CRP categories and mortality (death) after CABG surgery.
A total of 87 patients (9.5 percent) died over a mean postoperative follow-up period of 4.8+/-1.5 years. Using a proportional-
"The findings confirm that patients with circulating CRP levels >10 mg/L are at greater risk for adverse events when compared with patients in the lowest preoperative CRP level (< 1mg/L),” said Dr. Perry. “Of great interest is the finding that patients with preoperative levels as low as even 3 mg/L required a longer hospital stay and were at significant risk for increased mortality up to five years after surgery.”
Dr. Perry suggested that his findings indicate not only that CRP levels are an important predictor of adverse outcomes in otherwise low-risk cardiac surgical patients undergoing routine CABG surgery, but also that CRP levels may be a target for perioperative therapeutic intervention to reduce the risk for adverse events after surgery.”
Press release courtesy of the "American Society of Anesthesiologists."
