The Relationship Between Serum Free Fatty Acids Before Coronary Artery Bypass Grafting And The Risk Of Adverse Cardiovascular Events After Surgery

[Objective]The study aims to evaluate whether preoperative serum free fatty acid(FFA)levels predict early postoperative as well as a follow-up of 1 year adverse cardiovascular events among petients undergoing coronary artery bypass grafting surgery.[Methods]The study prospectively enrolled 250 patients undergoing coronary artery bypass grafting surgery in Fuwai Hospital between September of 2013 and December of 2013,and carried out a follow-up of 1 year for all of these cases.SinoSCORE and EuroSCORE II were calculated for every patient.The area under the receiver-operating characteristic curves(ROC-AUC)were used to determine the ability of preoperative serum FFA level as a risk factor for postoperative and one-year cardiovascular complications,prolongedduration of mechanical ventilation、intensive care unit and postoperative hospitalstay,and were compared with SinoSCORE and EuroSCOREⅡ.[Results]Serum fee fatty acid achieved a satisfactory performance with the good value for the early postoperative and 1 year follow-up adverse cardiovascular events,including perioperation myocardial infarction(PMI)(AUC=0.762 95%CI 0.615~0.909),postoperative recurrence of angina(AUC=0.723 95%CI 0.628~0.818)and major adverse cardiovascular events(MACE)(AUC=0.707 95%CI 0.573~0.842);and showed no predictive value for prolonged duration of mechanical ventilation and the postoperative hospitalstay..For preoperative serum free fatty acid concentration,the optimal cut-off values for predition for perioperation myocardial infarction、postoperative recurrence of angina and MACE were 0.6150.0.4150 and 0.6150,respectively.Compared with serum FFA,SinoSCORE and EuroSCORE Ⅱ performed less predictive value for adverse cardiovascular events,and better prognostic value for other poor outcomes.Adjusted by multivariable analysis,preoperative serum FFA also has good value for predicting postoperative recurrence of angina、PMI and MACE(AUC=0.69.0.75.0.70,P=0.042.0.13、0.095),the outcomes of AUC are also higher than SinoSCORE and EuroSCORE II,for major adverse cardiovascular events,the AUC of FFA apparently higher than SinoSCORE,and a little higher than EuroSCORE II,for perioperation myocardial infarction,The AUC values of the three are similar.[Conclusions]Preoperative serum fee fatty acid level yield good predictive value for the major adverse cardiovascular events in the early postoperative and 1-year follow-up period after coronary artery bypass grafting surgery.