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Predictors of long-term mortality and cardiac events in patients with known or suspected coronary artery disease who survive major non-cardiac surgery
Authors:Filipovic M  Jeger R V  Girard T  Probst C  Pfisterer M  Gürke L  Studer W  Seeberger M D
Institution:Department of Anaesthesia, University Hospital Basel, CH 4031 Basel, Switzerland. mfilipovic@uhbs.ch
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.
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