Predictors of long-term mortality and cardiac events in patients with known or suspected coronary artery disease who survive major non-cardiac surgery

Anaesthesia. 2005 Jan;60(1):5-11. doi: 10.1111/j.1365-2044.2004.03996.x.

Abstract

The aim of this prospective study was to assess predictors of long-term outcome in patients with documented or suspected coronary artery disease who survive major non-cardiac surgery. The impact of patients' comorbidities, pre-operative heart rate variability and postoperative increase in cardiac troponin I on all-cause mortality and major cardiac events within 2 years was explored using multivariable logistic regression. Six of 173 patients died within the first month after surgery and were excluded from the study. Thirty-four of 167 patients (20%) died 1-24 months after surgery. Independent predictors of all-cause mortality were history of congestive heart failure (odds ratio 6.4 [95%, confidence interval 1.7-24]), pre-operatively depressed heart rate variability (odds ratio 6.4 [95%, confidence interval 1.9-21]), and age > 70 years (odds ratio 4.5 [95%, confidence interval 1.2-16]). In contrast, postoperative elevation of cardiac troponin I did not independently predict all-cause mortality or major cardiac events.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Cause of Death*
  • Coronary Disease / complications*
  • Female
  • Heart Diseases / etiology
  • Heart Failure / complications
  • Heart Rate
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Surgical Procedures, Operative* / mortality
  • Survival Analysis
  • Troponin I / metabolism

Substances

  • Biomarkers
  • Troponin I