engleski

Individual differences in core inflammatory markers'expression after cardiopulmonary bypass: comparison of IL-6, CRP, neopterin and complement

Cardiac surgery with the use of cardiopulmonary bypass (CPB) induces a state of systemic inflammatory response during which different plasma proteins and blood cells are activated. So far, various inflammatory markers were used to monitor that response but neither of them was found to be sensitive and specific enough. The aim of this study was to investigate whether the use of cardiopulmonary bypass emphasizes interindividual differences of core inflammatory markers' expression after cardiac surgery. //Eighty consecutive patients undergoing myocardial revascularization were divided in two groups prospectively: group CABG (n=35) and group OPCAB (n=45). Serum samples were collected one day prior to surgery, 6, 12 and 24 hours after the end of surgery and on 3rd, 5th and 7th day postoperatively. Interleukin-6 and neopterin were measured using ELISA method, C3, C4 and CRP using turbidimetric method. Due to the potential interindividual variations in marker levels, we have analyzed "hyper-responders" (patients demonstrating the peak values greater or equal to the population median for a given inflammatory marker) for each inflammatory marker between the groups, 12 hours after surgery, with respect to multiple variables. //Interleukin-6 and CRP kinetics did not differ between groups. Interleukin-6 showed peak level 12 hours after the end of surgery, while CRP showed peak level 3rd postoperative day. Complement C4 levels were much lower during the first 24 hours after surgery in CABG hyper-responders compared with OPCAB hyper-responders (p=0.019 ; p=0.027 and p=0.019 for 6, 12 and 24 hours after the end of surgery, respectively). Neopterin levels were higher during first 24 hours postoperatively in CABG hyper-responders (p=0.016, p=0.014 and p=0.014 for 6, 12 and 24 hours after the end of surgery, respectively).

CRP; interleukin 6; neopterin; complement; cardiac surgery

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