Diabetic Patients Have Increased Perioperative Cardiac Risk in Heart-Type Fatty Acid-Binding Protein-Based Assessment

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Sari M., KILIÇ H., Ariturk O. K., YAZIHAN N., AKDEMİR R.

MEDICAL PRINCIPLES AND PRACTICE, cilt.24, sa.1, ss.53-57, 2015 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 24 Sayı: 1
  • Basım Tarihi: 2015
  • Doi Numarası: 10.1159/000368756
  • Dergi Adı: MEDICAL PRINCIPLES AND PRACTICE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.53-57
  • Anahtar Kelimeler: Diabetes mellitus, Fatty acids, Ischemia, Risk factors, Risk management, Troponin, ACUTE MYOCARDIAL-INFARCTION, ACUTE CORONARY SYNDROME, LONG-TERM MORTALITY, NONCARDIAC SURGERY, TROPONIN-T, MARKERS, INJURY, COMPLICATIONS, VALIDATION, PREDICTION
  • Ankara Üniversitesi Adresli: Evet

Özet

Objective: To test the potential role of heart-type fatty acid-binding protein (H-FABP) in detecting increased perioperative cardiac risk in comparison with cardiac troponin I (cTnI) in the early postoperative period. Subjects and Methods: Sixty-seven patients who had clinical risk factors and underwent elective intermediate - or high-risk noncardiac surgery were included in this study. Serum specimens were analyzed for H-FABP and cTnI levels before and at 8 h after surgery. None of the patients had chest pain; 27 had a history of ischemic heart disease, 3 of heart failure, 5 of cerebrovascular diseases, 40 of diabetes and 46 of hypertension. Results: The mean duration of the operations was 2.33 +/- 1.27 h (range 1-6). In the postoperative period, 27 (40.3%) patients had increased H-FABP levels (= 7.5 ng/ml); the median preoperative serum H-FABP level was 0.13 ng/ml (<0.1-5.9) and the median postoperative H-FABP level was 6.86 ng/ml (<0.1-13.7). Only 1 (1.5%) patient had cTnI >0.1 mu g/l during the postoperative period. Correlation analysis revealed that the presence of diabetes was associated with an increased H-FABP level (r = 0.30, p = 0.01). Of the 27 patients with H-FABP = 7.5 ng/ml, 21 (87%) had diabetes. There was no significant correlation with other clinical risk factors, type or duration of surgery. Conclusion: The H-FABP levels significantly increased in the postoperative period. Most patients with increased postoperative H-FABP levels were diabetic. High HFABP levels could alert clinicians to increased perioperative cardiovascular risk and could prevent underdiagnosis, especially in diabetic patients. (C) 2014 S. Karger AG, Basel