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Pre‐operative platelet‐bound CD40 ligand is probably associated with peri‐operative cardiac events in hip and knee arthroplasty
Author(s) -
Ray Michael J.,
Calabro Lorenzo J.,
Sirisena Tilak,
Crawford Scott A.,
Crawford Ross W.,
Walters Darren L.
Publication year - 2010
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.2010.02289.x
Subject(s) - medicine , biomarker , cardiology , platelet , cardiac surgery , arthroplasty , platelet activation , surgery , chemistry , biochemistry
Eur J Clin Invest 2010; 40 (6): 497–503 Abstract Background Peri‐operative cardiac events are common and associated with significant morbidity. A predictive biomarker would assist in pre‐operative risk stratification of surgical patients. This study explored the utility of pre‐operative measurements of platelet‐bound CD40 ligand and other biomarkers for predicting peri‐operative cardiac events in total hip or knee arthroplasty. Methods Blood samples were collected from 62 patients prior to surgery and tested for the biomarkers platelet CD40 ligand, platelet factor V/Va, platelet P‐selectin, high‐sensitivity C‐reactive protein, B‐type natriuretic peptide and soluble CD40 ligand. The Revised Cardiac Risk Index was also calculated. Patients were then followed up prospectively and screened for peri‐operative cardiac events by means of ECG, serial troponin I, a cardiologist’s review and an interview at 6 weeks post operation. Results Six of 62 (9·7%) patients had a cardiac event. Patients who experienced a cardiac event had higher pre‐operative platelet CD40 ligand levels as measured by flow cytometry [median 0·55% vs. 0·29% ( P = 0·02)]. In this sized sample, platelet CD40L was the only biomarker independently associated with cardiac events ( P = 0·02), the area under the receiver–operator characteristic curve being 0·79. Conclusion In a study of this number of patients, of the six biomarkers tested, only platelet CD40 ligand was found to have a probable association with peri‐operative cardiac events in hip and knee arthroplasty.