Informativeness of various predictors of perioperative cardiovascular complications in non-cardiac surgery
The objective was to perform a comparative analysis of the information content of potential predictors of cardiovascular complications of various types in patients operated on for vascular diseases. Materials and Methods. We examined 129 patients aged 66 [61–70] years who underwent elective vascul...
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| Language: | Russian |
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New Terra Publishing House
2023-05-01
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| Series: | Вестник анестезиологии и реаниматологии |
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| Online Access: | https://www.vair-journal.com/jour/article/view/790 |
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| author | D. A. Sokolov I. A. Kozlov |
| author_facet | D. A. Sokolov I. A. Kozlov |
| author_sort | D. A. Sokolov |
| collection | DOAJ |
| description | The objective was to perform a comparative analysis of the information content of potential predictors of cardiovascular complications of various types in patients operated on for vascular diseases. Materials and Methods. We examined 129 patients aged 66 [61–70] years who underwent elective vascular surgery. We analyzed comorbidity, general clinical indicators, special cardiac risk indices and biomarkers: N-terminal segment of B-type natriuretic peptide prohormone (NT-proBNP) and cardiospecific troponin I. We used logistic regression and ROC analysis. Results. 21 (16.3 %) perioperative cardiovascular complications were registered in 17 (13.2 %) patients. In one-factor regression, the predictors of cardiovascular complications were coronary heart disease (OR 4.5904; 95 % CI 1.3119–5.9340; p = 0.0171), combination of coronary heart disease and chronic heart failure (OR 2.9419; 95 % CI 1.0140–8.5350; p = 0.047), ASA class > 3 (OR 2.9402; 95 % CI 1.0304–8.3899; p = 0.0438), high cardiac risk surgery (OR 3.4741; 95 % CI 1.1162-10.8126; p = 0.0316), Lee cardiac risk index (OR 2.2353; 95 % CI 1.2842–3.8911; p = 0.0045), the American College of Surgeons cardiac risk index for assessing the risk of perioperative myocardial infarction or cardiac arrest (OR 1.5312; 95 % CI 1.0927–2.1456; p = 0.0133) and the preoperative level of the N-terminal prohormone B-type natriuretic peptide (NT-proBNP) (OR 1.0048; 95 % CI 1.0021–1.0074; p = 0.0004). In multivariate regression, the predictors of cardiovascular complications were high-risk cardiac surgery (OR 5.7439; 95 % CI 1.1027–29.9181; p = 0.0379) and NT-proBNP (OR 1.0044; 95 % CI 1.0015–1.0073; p = 0.0033). The biomarker level > 218 pg/ml discriminated against cardiovascular complications with sensitivity of 82.4 % and specificity of 85.3 % (AUC 0.825; 95 % CI 0.747–0.887; p < 0.0001). Conclusion. In vascular interventions, the most significant predictors of cardiovascular complications are high-risk cardiac surgery and the preoperative level of NT-proBNP > 218 pg/ml with a sensitivity and specificity level exceeding 80 %. |
| format | Article |
| id | doaj-art-d6e75d69c99b42559d5a72d5c119a33a |
| institution | Kabale University |
| issn | 2078-5658 2541-8653 |
| language | Russian |
| publishDate | 2023-05-01 |
| publisher | New Terra Publishing House |
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| series | Вестник анестезиологии и реаниматологии |
| spelling | doaj-art-d6e75d69c99b42559d5a72d5c119a33a2025-08-20T03:56:32ZrusNew Terra Publishing HouseВестник анестезиологии и реаниматологии2078-56582541-86532023-05-0120261610.24884/2078-5658-2022-20-2-6-16589Informativeness of various predictors of perioperative cardiovascular complications in non-cardiac surgeryD. A. Sokolov0I. A. Kozlov1Yaroslavl State Medical University; Regional Clinical HospitalMoscow Regional Research Clinical Institute named after. M. F. VladimirskyThe objective was to perform a comparative analysis of the information content of potential predictors of cardiovascular complications of various types in patients operated on for vascular diseases. Materials and Methods. We examined 129 patients aged 66 [61–70] years who underwent elective vascular surgery. We analyzed comorbidity, general clinical indicators, special cardiac risk indices and biomarkers: N-terminal segment of B-type natriuretic peptide prohormone (NT-proBNP) and cardiospecific troponin I. We used logistic regression and ROC analysis. Results. 21 (16.3 %) perioperative cardiovascular complications were registered in 17 (13.2 %) patients. In one-factor regression, the predictors of cardiovascular complications were coronary heart disease (OR 4.5904; 95 % CI 1.3119–5.9340; p = 0.0171), combination of coronary heart disease and chronic heart failure (OR 2.9419; 95 % CI 1.0140–8.5350; p = 0.047), ASA class > 3 (OR 2.9402; 95 % CI 1.0304–8.3899; p = 0.0438), high cardiac risk surgery (OR 3.4741; 95 % CI 1.1162-10.8126; p = 0.0316), Lee cardiac risk index (OR 2.2353; 95 % CI 1.2842–3.8911; p = 0.0045), the American College of Surgeons cardiac risk index for assessing the risk of perioperative myocardial infarction or cardiac arrest (OR 1.5312; 95 % CI 1.0927–2.1456; p = 0.0133) and the preoperative level of the N-terminal prohormone B-type natriuretic peptide (NT-proBNP) (OR 1.0048; 95 % CI 1.0021–1.0074; p = 0.0004). In multivariate regression, the predictors of cardiovascular complications were high-risk cardiac surgery (OR 5.7439; 95 % CI 1.1027–29.9181; p = 0.0379) and NT-proBNP (OR 1.0044; 95 % CI 1.0015–1.0073; p = 0.0033). The biomarker level > 218 pg/ml discriminated against cardiovascular complications with sensitivity of 82.4 % and specificity of 85.3 % (AUC 0.825; 95 % CI 0.747–0.887; p < 0.0001). Conclusion. In vascular interventions, the most significant predictors of cardiovascular complications are high-risk cardiac surgery and the preoperative level of NT-proBNP > 218 pg/ml with a sensitivity and specificity level exceeding 80 %.https://www.vair-journal.com/jour/article/view/790cardiac risk indicespredictors of complicationsnatriuretic peptidesnt-probnpnon-cardiac surgeryperioperative cardiovascular complicationscardiac complications |
| spellingShingle | D. A. Sokolov I. A. Kozlov Informativeness of various predictors of perioperative cardiovascular complications in non-cardiac surgery Вестник анестезиологии и реаниматологии cardiac risk indices predictors of complications natriuretic peptides nt-probnp non-cardiac surgery perioperative cardiovascular complications cardiac complications |
| title | Informativeness of various predictors of perioperative cardiovascular complications in non-cardiac surgery |
| title_full | Informativeness of various predictors of perioperative cardiovascular complications in non-cardiac surgery |
| title_fullStr | Informativeness of various predictors of perioperative cardiovascular complications in non-cardiac surgery |
| title_full_unstemmed | Informativeness of various predictors of perioperative cardiovascular complications in non-cardiac surgery |
| title_short | Informativeness of various predictors of perioperative cardiovascular complications in non-cardiac surgery |
| title_sort | informativeness of various predictors of perioperative cardiovascular complications in non cardiac surgery |
| topic | cardiac risk indices predictors of complications natriuretic peptides nt-probnp non-cardiac surgery perioperative cardiovascular complications cardiac complications |
| url | https://www.vair-journal.com/jour/article/view/790 |
| work_keys_str_mv | AT dasokolov informativenessofvariouspredictorsofperioperativecardiovascularcomplicationsinnoncardiacsurgery AT iakozlov informativenessofvariouspredictorsofperioperativecardiovascularcomplicationsinnoncardiacsurgery |