Abstract: Objective to determine the value of preoperative high-sensitivity C-reactive protein (hsCRP) in predicting perioperative cardiac events (PCE) in elderly patients with coronary artery disease (CAD) undergoing non-cardiac surgery. Methods A prospective cohort study was conducted. 81 patients with the diagnosis of CAD undergoing major non-cardiac surgery were enrolled. hsCRP concentration was measured before surgery. Clinical variables were evaluated. The PCE were followed by the examinations of 12-lead ECG and Troponin I (cTnI) levels. Results PCE occurred in 32% of the patients. Using receiver operating characteristic (ROC) analysis, hsCRP predicted PCE with the area under the curve of 0.75(95%CI, 0.64-0.87; p<0.05). The cutoff value was 12mg/L, showing a sensitivity of 30.77% and specificity of 94.55%. Multivariate analysis revealed that hsCRP＞12mg/L as independent predictor for PCE (RR, 26.29; 95%CI, 2.46-281.42; p<0.01), and had higher predictive accuracy than Revised cardiac risk index (RCRI). Conclusion In elderly patients with CAD undergoing non-cardiac surgery, preoperatvie hsCRP is an independent predictor of PCE. hsCRP> 12mg/L identified patients at higher risk.

Key words: coronary artery disease, non-cardiac surgery, hsCRP, perioperative cardiac events