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Objective: There is limited evidence that increased preoperative levels of C-reactive protein are associated with
increased mortality after coronary artery bypass grafting. We retrospectively investigated in 5669 patients the predictive
value of preoperative C-reactive protein levels for early and late mortalities after coronary artery bypass
grafting.
Methods: Patients undergoing isolated coronary artery bypass grafting between January 2000 and December
2007 (n ј 8500) were studied. Preoperative demographic data and risk factors and outcome data (mortality
data) were prospectively collected in a database. Preoperative C-reactive protein levels were retrieved from the
laboratory data.
Results: In 5669 of 8500 cases, the preoperative C-reactive protein level could be retrieved. Seventy-five patients
were unavailable for follow-up. A preoperative C-reactive protein level greater than 10 mg/L was an independent
risk factor for early mortality, whereas a level greater than 5 mg/L was a risk factor for late mortality. Other risk
factors were age, sex, chronic obstructive pulmonary disease, diabetes, left ventricular ejection fraction less than
35 %, peripheral vascular disease, and previous cardiac surgery. We found a higher mean C-reactive protein value
in patients with a left ventricular ejection fraction less than 35 %(18.5 33 mg/L) than in those with an ejection
fraction greater than 35 % (P<.0001).
Conclusions: Preoperative C-reactive protein levels can be used in risk stratification in coronary artery bypass
grafting surgery.A C-reactive protein level greater than 10 mg/L is a risk factor for early mortality, whereas a level
greater than 5 mg/L is a risk factor for late mortality.
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