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A meta‐analysis of the utility of C‐reactive protein in predicting early, intermediate‐term and long term mortality and major adverse cardiac events in vascular surgical patients
Author(s) -
Padayachee L.,
Rodseth R. N.,
Biccard B. M.
Publication year - 2009
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2008.05786.x
Subject(s) - mace , medicine , myocardial infarction , cardiology , odds ratio , confidence interval , cardiac surgery , prospective cohort study , surgery , percutaneous coronary intervention
Summary We conducted a meta‐analysis of the utility of pre‐operative C reactive protein (CRP) in predicting early (< 30 days), intermediate (30–180 days) and long term (> 180 days) mortality and major adverse cardiac events (MACE; cardiac mortality and nonfatal myocardial infarction (MI) combined) following vascular surgery. Of 291 studies identified, ten prospective patient cohorts were identified. A pre‐operative CRP > 3 mg.l −1 was not associated with 30‐day all‐cause mortality, cardiac mortality, nonfatal myocardial infarction or MACE. Intermediate‐term all‐cause mortality, cardiac death and MACE showed a trend to a worse outcome (odds ratio (OR) 9.07, 95% confidence interval (CI) 0.86–96.28, p = 0.07; OR 8.71, 95% CI 0.5–153.1, p = 0.14 and OR 2.81, 95% CI 0.78–5.18, p = 0.15 respectively). Long term all cause mortality (OR 2.40, 95% CI 1.15–5.02, p = 0.02), cardiac death (OR 5.66, 95% CI 1.71–18.73, p = 0.005) and MACE (OR 2.76, 95% CI 1.38–5.55, p = 0.004) were significantly increased.