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Eur J Cardiothorac Surg 2006;29:983-985
© 2006 Elsevier Science NL

Preoperative C-reactive protein is predictive of long-term outcome after coronary artery bypass surgery

Division of Cardio-thoracic and Vascular Surgery, Department of Surgery, Oulu University Hospital, P.O. Box 21, 90029 Oulu, Finland

Received 8 December 2005; received in revised form 25 January 2006; accepted 9 February 2006.

^_* Corresponding author. Tel.: +358 8 315 2813/40 733973; fax: +358 8 315 2577. (Email: faustobiancari{at}yahoo.it).

Background: Increased levels of C-reactive protein (CRP) are associated with the presence and severity of atherosclerosis, and with increased risk of coronary events as well as of cardiac events after coronary percutaneous intervention. Methods: We have investigated whether preoperative CRP had an impact on the long-term outcome of 843 patients who underwent on-pump coronary artery bypass surgery (CABG). Results: Among operative survivors, patients with preoperative CRP <1.0 mg/dL had significantly better 12-year overall survival rate (74.1% vs 63.0%, p = 0.004) and survival freedom from fatal cardiac event (86.7% vs 78.1%). Multivariate analysis including patients’ age, extracardiac arteriopathy, urgent/emergent operation, recent myocardial infarction, congestive heart failure, left ventricular ejection fraction, atrial fibrillation, transient ischemic attack/stroke, number of distal anastomoses, diabetes, and preoperative CRP 1.0 mg/dL or <1.0 mg/dL, showed that the latter was an independent predictor of late all-cause mortality (p = 0.017, RR 1.60, 95% CI 1.09–2.35). Its impact on overall survival was particularly evident in patients with left ventricular ejection fraction <50% (CRP < 1.0 mg/dL: 58.7% vs CRP 1.0 mg/dL: 43.7%, p < 0.00001). Conclusions: Increased preoperative levels of CRP are associated with significantly decreased overall survival after primary on-pump CABG.

Key Words: Coronary artery bypass surgery • C-reactive protein • Survival

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