Key result
Combining clinical scores with NT-proBNP and hs-CRP improves MACE prediction in elderly vascular surgery patients.
Why the study?
Major vascular surgery carries high cardiac risk and advancing age predicts adverse outcomes, necessitating accurate risk stratification combining risk scores and biomarkers to detect occult disease and reduce perioperative mortality.
Combining biomarkers such as NT-proBNP and hs-CRP with clinical risk scores improves the prediction of perioperative and postoperative cardiovascular complications in elderly patients undergoing major vascular surgery.
May aid perioperative risk stratification in elderly vascular surgery patients; hypothesis-generating and requires prospective validation.
Reliance on surgery, improvements in surgical techniques, and perioperative management have led to a dramatic increase in the frequency of surgical procedures in the elderly population. According to the European Society of Cardiology and the European Society of Anaesthesiology and Intensive Care, major vascular surgery is defined as high-risk, considering the frequency of myocardial infarction and cardiac arrest, which is higher than 5%. Age is an independent predictor of myocardial infarction and cardiac arrest. Heart function alterations are primary changes that occur with advancing age. Risk stratification represents a set of procedures that include identifying chronic systemic diseases, determining their severity, stability and the need for further evaluation and/or therapy optimization, with the aim of reducing perioperative and postoperative mortality and morbidity. In addition to the application of risk scores, accurate risk stratification requires the combined application of both preoperative and postoperative biomarkers. The main idea of integrating biomarkers with scoring systems is to reveal those patients with clinically unmanifested disease, who carry a mortality risk and remain undetected by scoring systems. Biomarkers, such as NT-proBNP and highly sensitive C-reactive protein, have the greatest predictive influence in geriatric vascular surgery.
No takes yet. Share an insight, caveat, or question.
Perić et al. (2022) conducted a review in Major vascular surgery in the geriatric population. Cardiac risk stratification (risk scores and biomarkers) was evaluated. Combining clinical risk scores with biomarkers such as NT-proBNP and hs-CRP improves the prediction of major adverse cardiovascular events in elderly patients undergoing major vascular surgery.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: