Preoperative values of inflammatory markers predict clinical outcomes in patients after CABG, regardless of the use of cardiopulmonary bypass
Objective: The impact of systemic inflammation on clinical outcomes after CABG surgery is still controversial. In this study, we evaluated the impact of the markers of inflammation, endothelial damage and platelet activation on clinical outcomes after on- and off-pump CABG. Methods: A group of 191 c...
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| Format: | Article |
| Language: | English |
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Elsevier
2016-12-01
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| Series: | Indian Heart Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483216305338 |
| _version_ | 1819173201296490496 |
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| author | Dariusz Plicner Jarosław Stoliński Marcin Wąsowicz Bugusław Gawęda Hubert Hymczak Bogusław Kapelak Rafał Drwiła Anetta Undas |
| author_facet | Dariusz Plicner Jarosław Stoliński Marcin Wąsowicz Bugusław Gawęda Hubert Hymczak Bogusław Kapelak Rafał Drwiła Anetta Undas |
| author_sort | Dariusz Plicner |
| collection | DOAJ |
| description | Objective: The impact of systemic inflammation on clinical outcomes after CABG surgery is still controversial. In this study, we evaluated the impact of the markers of inflammation, endothelial damage and platelet activation on clinical outcomes after on- and off-pump CABG.
Methods: A group of 191 consecutive on- and off-pump CABG patients were prospectively studied. Blood samples were drawn before surgery, 18–36 h after the procedure and 5–7 days postoperatively and analyzed for 8-iso-prostaglandin F2α (8-iso-PGF2α), asymmetric dimethylarginine (ADMA) and β-thromboglobulin (β-TG). White blood count and C-reactive protein were measured twice, first before and then during the first 18–36 h after CABG. The primary clinical end-points were: low cardiac output syndrome (LCOS), postoperative myocardial infarction (PMI) and in-hospital cardiovascular death.
Results: Elevation of 8-iso-PGF2α, ADMA and β-TG before surgery was associated with an increased risk of morbidity and mortality after CABG. There were no differences in analyzed markers and clinical outcomes between the on- and off-pump groups. Even during the uncomplicated postoperative course the inflammatory response was enhanced and still remained higher than baseline 5–7 days after surgery.
Conclusion: Links between preoperative 8-iso-PGF2α, ADMA and β-TG and unfavorable early post-CABG outcomes suggest that these markers could be useful in identifying patients with increased risk of LCOS, PMI and in-hospital cardiovascular death following elective CABG. |
| first_indexed | 2024-12-22T20:19:19Z |
| format | Article |
| id | doaj.art-18d530ab566e456d855b746739ac9d20 |
| institution | Directory Open Access Journal |
| issn | 0019-4832 |
| language | English |
| last_indexed | 2024-12-22T20:19:19Z |
| publishDate | 2016-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Heart Journal |
| spelling | doaj.art-18d530ab566e456d855b746739ac9d202022-12-21T18:13:53ZengElsevierIndian Heart Journal0019-48322016-12-0168S3S10S1510.1016/j.ihj.2016.10.002Preoperative values of inflammatory markers predict clinical outcomes in patients after CABG, regardless of the use of cardiopulmonary bypassDariusz Plicner0Jarosław Stoliński1Marcin Wąsowicz2Bugusław Gawęda3Hubert Hymczak4Bogusław Kapelak5Rafał Drwiła6Anetta Undas7Department of Cardiosurgery, John Paul II Hospital, Krakow, PolandDepartment of Cardiosurgery, John Paul II Hospital, Krakow, PolandDepartment of Anesthesia, Toronto General Hospital, University of Toronto, Toronto, CanadaDepartment of Cardiosurgery, John Paul II Hospital, Krakow, PolandDepartment of Anesthesia, John Paul II Hospital, Krakow, PolandDepartment of Cardiosurgery, John Paul II Hospital, Krakow, PolandDepartment of Anesthesia, John Paul II Hospital, Krakow, PolandInstitute of Cardiology, Jagiellonian University Medical College, Krakow, PolandObjective: The impact of systemic inflammation on clinical outcomes after CABG surgery is still controversial. In this study, we evaluated the impact of the markers of inflammation, endothelial damage and platelet activation on clinical outcomes after on- and off-pump CABG. Methods: A group of 191 consecutive on- and off-pump CABG patients were prospectively studied. Blood samples were drawn before surgery, 18–36 h after the procedure and 5–7 days postoperatively and analyzed for 8-iso-prostaglandin F2α (8-iso-PGF2α), asymmetric dimethylarginine (ADMA) and β-thromboglobulin (β-TG). White blood count and C-reactive protein were measured twice, first before and then during the first 18–36 h after CABG. The primary clinical end-points were: low cardiac output syndrome (LCOS), postoperative myocardial infarction (PMI) and in-hospital cardiovascular death. Results: Elevation of 8-iso-PGF2α, ADMA and β-TG before surgery was associated with an increased risk of morbidity and mortality after CABG. There were no differences in analyzed markers and clinical outcomes between the on- and off-pump groups. Even during the uncomplicated postoperative course the inflammatory response was enhanced and still remained higher than baseline 5–7 days after surgery. Conclusion: Links between preoperative 8-iso-PGF2α, ADMA and β-TG and unfavorable early post-CABG outcomes suggest that these markers could be useful in identifying patients with increased risk of LCOS, PMI and in-hospital cardiovascular death following elective CABG.http://www.sciencedirect.com/science/article/pii/S0019483216305338Cardiopulmonary bypassCoronary artery bypass graftingInflammation |
| spellingShingle | Dariusz Plicner Jarosław Stoliński Marcin Wąsowicz Bugusław Gawęda Hubert Hymczak Bogusław Kapelak Rafał Drwiła Anetta Undas Preoperative values of inflammatory markers predict clinical outcomes in patients after CABG, regardless of the use of cardiopulmonary bypass Indian Heart Journal Cardiopulmonary bypass Coronary artery bypass grafting Inflammation |
| title | Preoperative values of inflammatory markers predict clinical outcomes in patients after CABG, regardless of the use of cardiopulmonary bypass |
| title_full | Preoperative values of inflammatory markers predict clinical outcomes in patients after CABG, regardless of the use of cardiopulmonary bypass |
| title_fullStr | Preoperative values of inflammatory markers predict clinical outcomes in patients after CABG, regardless of the use of cardiopulmonary bypass |
| title_full_unstemmed | Preoperative values of inflammatory markers predict clinical outcomes in patients after CABG, regardless of the use of cardiopulmonary bypass |
| title_short | Preoperative values of inflammatory markers predict clinical outcomes in patients after CABG, regardless of the use of cardiopulmonary bypass |
| title_sort | preoperative values of inflammatory markers predict clinical outcomes in patients after cabg regardless of the use of cardiopulmonary bypass |
| topic | Cardiopulmonary bypass Coronary artery bypass grafting Inflammation |
| url | http://www.sciencedirect.com/science/article/pii/S0019483216305338 |
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