Key result
Pre-operative CRP > 3 mg/L in vascular surgery patients was significantly associated with increased long-term all-cause mortality (OR 2.40; 95% CI 1.15-5.02; p=0.02) and MACE.
Why the study?
Does pre-operative CRP > 3 mg/L predict early, intermediate, and long-term mortality and MACE in vascular surgical patients?
Meta-Analysis
Does pre-operative CRP > 3 mg/L predict early, intermediate, and long-term mortality and MACE in vascular surgical patients?
Odds Ratio: 2.4 (95% CI 1.15–5.02)
p-value: p=0.02
Elevated pre-operative CRP (> 3 mg/L) is a significant predictor of long-term mortality and major adverse cardiac events following vascular surgery.
May refine long-term risk stratification in vascular surgery; supports further trials on CRP-targeted interventions.
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 x 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.
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Padayachee et al. (2009) conducted a meta-analysis in Vascular surgery. Pre-operative C-reactive protein > 3 mg/L vs. Pre-operative C-reactive protein ≤ 3 mg/L was evaluated on Long term (> 180 days) all cause mortality (OR 2.40, 95% CI 1.15-5.02, p=0.02). Pre-operative CRP > 3 mg/L in vascular surgery patients was significantly associated with increased long-term all-cause mortality (OR 2.40; 95% CI 1.15-5.02; p=0.02) and MACE.
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