Impact of Preoperative C-Reactive Protein on Midterm Outcomes after Off-Pump Coronary Artery Bypass Grafting

Abstract

Background: We aimed to assess the impact of C-reactive protein (CRP) on clinical outcomes after off-pump coronary artery bypass grafting (OPCABG).

Methods: Seven hundred fifty-five consecutive OPCABG patients were divided into two groups according to their preoperative CRP level (normal CRP [NCRP] group [CRP ≤ 6.0 mg/L] versus high CRP [HCRP] group [CRP > 6.0 mg/L]). Outcome measurements were cardiac death and major adverse cardiac and cerebrovascular event (MACCE).

Results: Early mortality was higher in the HCRP group (p = 0.036). During follow-up, cardiac mortality was 1.2% in the NCRP group and 7.1% in the HCRP group (p < 0.001). The overall MACCE incidence was 11.2% in the NCRP group and 16.5% in the HCRP group (p = 0.042). All-cause mortality was the only determining factor (p < 0.001), whereas the incidences of myocardial infarction, stroke, and repeat revascularization were similar between the two groups (p = 0.987, p = 0.201, p = 0.426). The 3-year freedom rates from cardiac death and MACCE were 98.8 ± 0.5% and 87.5 ± 1.6% in the NCRP group and 92.5 ± 1.7% and 84.3 ± 2.5% in the HCRP group (p < 0.001, p = 0.09, respectively).

Conclusions: Patients with HCRP level showed worse clinical outcomes regarding cardiac death and MACCE after OPCABG.