tailieunhanh - Báo cáo y học: "Insulin resistance, adiponectin and adverse outcomes following elective cardiac surgery: a prospective follow-up study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Insulin resistance, adiponectin and adverse outcomes following elective cardiac surgery: a prospective follow-up study. | Mikkelsen et al. Journal of Cardiothoracic Surgery 2010 5 129 http content 5 1 129 JOTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Insulin resistance adiponectin and adverse outcomes following elective cardiac surgery a prospective follow-up study Martin M Mikkelsen1 2 Troels K Hansen3 Jakob Gjedsted3 Niels H Andersen4 Thomas D Christensen1 Vibeke E Hjortdal1 S0ren P Johnsen2 Abstract Background Insulin resistance and adiponectin are markers of cardio-metabolic disease and associated with adverse cardiovascular outcomes. The present study examined whether preoperative insulin resistance or adiponectin were associated with short- and long-term adverse outcomes in non-diabetic patients undergoing elective cardiac surgery. Methods In a prospective study we assessed insulin resistance and adiponectin levels from preoperative fasting blood samples in 836 patients undergoing cardiac surgery. Population-based medical registries were used for postoperative follow-up. Outcomes included all-cause death myocardial infarction or percutaneous coronary intervention stroke re-exploration renal failure and infections. The ability of insulin resistance and adiponectin to predict clinical adverse outcomes was examined using receiver operating characteristics. Results Neither insulin resistance nor adiponectin were statistically significantly associated with 30-day mortality but adiponectin was associated with an increased 31-365-day mortality adjusted odds ratio 95 confidence interval comparing the upper quartile with the three lower quartiles. Insulin resistance was a poor predictor of adverse outcomes. In contrast the predictive accuracy of adiponectin area under curve 95 confidence interval was similar to that of the EuroSCORE area under curve 95 confidence interval and a model including adiponectin and the EuroSCORE had an area under curve of 95 confidence interval .