Abstract:

Objective To determine whether serum multibiomarkers are effective in screening patients with high risks for perioperative myocardial infarction. Methods A total of 203 patients undergoing elective percutaneous coronary intervention (PCI) were enrolled. The mean age of patients was (65±9) years, 68.5% were males, and 60.6% were diagnosed with acute coronary syndrome (ACS). Serum biomarkers including high-sensitivity C-reactive protein (hs-CRP), brain natriuretic peptide (BNP) and D-dimer were measured before PCI and 12 h to 18 h after PCI. Results Perioperative myocardial infarction occurred in 67 patients (33.0%). The percents of patients with preoperative BNP>100 pg/mL and hs-CRP>5.0 ng/mL in those with perioperative myocardial infarction were significantly higher than those in patients without perioperative myocardial infarction (32.8% vs 19.9%, P=0.042; 25.4% vs 13.2%, P=0.031). However, only the percent of patients with postoperative BNP>100 pg/mL in those with perioperative myocardial infarction was significantly higher than that in patients without perioperative myocardial infarction (41.8% vs 27.2%, P=0.036). There was no significant difference in the percents of patients with preoperative and postoperative D-dimer>0.5 mg/L between patients with perioperative myocardial infarction and those without perioperative myocardial infarction. Multivariate regression analysis revealed that hs-CRP> 5.0 ng/mL before PCI was an independent risk factor for perioperative myocardial infarction (OR: 2.445, 95%CI: 1.082-5.521, P=0.032). Conclusion The combined measurement of hs-CRP and BNP before PCI may help to screen patients with high risks for perioperative myocardial infarction.

Key words: percutaneous coronary intervention, myocardial infarction, high-sensitivity C-reactive protein, brain natriuretic peptide, D-dimer