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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 204 - 211 (8page)
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Background: The prognostic utility of cardiac biomarkers, high-sensitivity cardiac troponin I (hs-cTnI) and soluble suppression of tumorigenicity-2 (sST2), in non-cardiac surgery is not well-defined. We evaluated hs-cTnI and sST2 as predictors of 30-day major adverse cardiac events (MACE) in patients admitted to the surgical intensive care unit (SICU) following major non-cardiac surgery. Methods: hs-cTnI and sST2 concentrations were measured in 175 SICU patients immediately following surgery and for three days postoperatively. The results were analyzed in relation to 30-day MACE and were compared with the revised Goldman cardiac risk index (RCRI) score. Results: Overall, 30-day MACE was observed in 16 (9.1%) patients. hs-cTnI and sST2 concentrations differed significantly between the two groups with and without 30-day MACE (P <0.05). The maximum concentration of sST2 was an independent predictor of 30-day MACE (odds ratio=1.016, P =0.008). The optimal cut-off values of hs-cTnI and sST2 for predicting 30-day MACE were 53.0 ng/L and 182.5 ng/mL, respectively. A combination of hs-cTnI and sST2 predicted 30-day MACE better than the RCRI score. Moreover, 30-day MACE was observed more frequently with increasing numbers of above-optimal cut-off hs-cTnI and sST2 values (P <0.0001). Reclassification analyses indicated that the addition of biomarkers to RCRI scores improved the prediction of 30-day MACE. Conclusions: This study demonstrates the utility of hs-cTnI and sST2 in predicting 30-day MACE following non-cardiac surgery. Cardiac biomarkers would provide enhanced risk stratification in addition to clinical RCRI scores for patients undergoing major non-cardiac surgery.
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참고문헌 (30)
참고문헌 신청
McCarthy CP / 2017 / Usefulness of multiple biomarkers for predicting incident major adverse cardiac events in patients who underwent diagnostic coronary angiography (from the Catheter Sampled Blood Archive in Cardiovascular Disease [CASABLANCA] Study) / Am J Cardiol 120:25~32
Kip KE / 2008 / The problem with composite end points in cardiovsacular studies / J Am Coll Cardiol 51:701~707
Khuri SF / 1998 / The Department of Veterans Affairs' NSQIP: the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care. National VA Surgical Quality Improvement Program / Ann Surg 228:491~507
Lee TH / 1999 / Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery / Circulation 100:1043~1049
Devereaux PJ / 2005 / Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk / CMAJ 173:627~634
Kip KE / 2008 / The problem with composite end points in cardiovsacular studies / J Am Coll Cardiol 51:701~707
Khuri SF / 1998 / The Department of Veterans Affairs' NSQIP: the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care. National VA Surgical Quality Improvement Program / Ann Surg 228:491~507
Lee TH / 1999 / Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery / Circulation 100:1043~1049
Devereaux PJ / 2005 / Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk / CMAJ 173:627~634
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