Patelis Nikolaos, Kouvelos George N, Koutsoumpelis Andreas, Moris Demetrios, Matsagkas Miltiadis I, Arnaoutoglou Eleni
First Department of Surgery, Vascular Surgery Division, National & Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece.
Department of Surgery, Vascular Surgery Unit, Medical School, University of Ioannina, Ioannina, Greece.
J Clin Anesth. 2016 Sep;33:105-16. doi: 10.1016/j.jclinane.2016.03.021. Epub 2016 Apr 29.
Cardiovascular complications signify a major cause of morbidity and mortality in patients undergoing vascular surgery adversely affecting both short- and long-term prognosis. During the last decade, unmet needs for a distinct cardiovascular risk assessment have led to an intensive research for establishment of biomarkers with sufficient predictive value. This literature review aims in examining the value of several biomarkers in predicting the incidence of major adverse cardiac events in vascular surgery patients. We reviewed the English language literature and analyzed the biomarkers as independent predictors or in correlation with other factors. We found several biomarkers showing a significant predictive value for a major adverse cardiovascular event in patients undergoing vascular surgery. These biomarkers can be used in clinical practice as outcome predictors, although sensitivity and specificity varies. Detection of subclinical cardiovascular damage may improve total risk estimation and facilitate clinical assessment of patients at risk for future cardiovascular events. The wide variety of sensitivity and specificity in predicting a MACE of these biomarkers exert the need for future trials in which these markers will be tested as adjunctive tools of cardiovascular risk estimation scoring systems.
心血管并发症是血管手术患者发病和死亡的主要原因，对短期和长期预后均产生不利影响。在过去十年中，对独特心血管风险评估的未满足需求促使人们深入研究以建立具有足够预测价值的生物标志物。这篇文献综述旨在探讨几种生物标志物在预测血管手术患者主要不良心脏事件发生率方面的价值。我们回顾了英文文献，并将这些生物标志物作为独立预测因子或与其他因素相关联进行分析。我们发现几种生物标志物对接受血管手术的患者发生主要不良心血管事件具有显著预测价值。这些生物标志物可在临床实践中用作结局预测指标，尽管其敏感性和特异性各不相同。检测亚临床心血管损伤可能会改善总体风险评估，并有助于对未来有心血管事件风险的患者进行临床评估。这些生物标志物在预测主要不良心血管事件时具有广泛的敏感性和特异性差异，这表明有必要进行未来试验，在这些试验中将这些标志物作为心血管风险评估评分系统的辅助工具进行测试。
