Preoperative C-Reactive Protein Levels Predict Readmission Following Elective Vascular Surgery

Abstract

\n BackgroundC-reactive protein levels (CRP) may be reduced with long-term administration of ubiquinol (CoQ10) in patients with chronic ischemic heart disease but the impact of a short-term period of administration in patients undergoing elective vascular surgery is uncertain.MethodsA double-blind randomized controlled trial was implemented to determine whether preoperative administration of CoQ10 could reduce cardiac biomarker elevations. Patients were randomly assigned to CoQ10 (400 mg per day) versus Placebo for 3 days prior to surgery. BNP, troponin and CRP were obtained pre and post-surgery. The primary endpoint was peak BNP and secondary endpoints were length of stay and readmission.ResultsOne hundred and twenty-three patients were randomly assigned to CoQ10 (N=62) or Placebo (N=61) for 3 days pre-surgery. At 24 hours post-surgery, the group receiving CoQ10 had lower BNP levels with no intergroup differences in CRP. Within 1-year post-discharge, thirty-six (29%) were readmitted and preoperative risk for readmission (HR: 95% CI) included diabetes mellitus (3.60: 1.46-8.91), active smoking (3.55: 1.43-8.78) and CRP (1.35: 1.04-1.76). C-index for all three variables predicting readmission was 0.727. ConclusionsShort-term administration of CoQ10 reduced perioperative BNP but not CRP levels. CRP, along with diabetes and active smoking were independent predictors of readmission and should be targeted as a means of reducing subsequent rehospitalizations following elective vascular procedures.Trial Registrationclinicaltrials.gov Identifier: NCT03956017