Behavior of inflammatory markers of myocardial injury in cardiac surgery: laboratory correlation with the clinical picture of postpericardiotomy syndrome

Abstract

OBJECTIVE: To verify the association of serum markers of myocardial injury, such as troponin I, creatinine kinase, and creatinine kinase isoenzyme MB, and inflammatory markers, such as tumor necrosis factor alpha (TNF-alpha), C-reactive protein, and the erythrocyte sedimentation rate in the perioperative period of cardiac surgery, with the occurrence of possible postpericardiotomy syndrome. METHODS: This was a cohort study with 96 patients undergoing cardiac surgery assessed at the following 4 different time periods: the day before surgery (D0); the 3rd postoperative day (D3); between the 7th and 10th postoperative days (D7-10); and the 30th postoperative day (D30). During each period, we evaluated demographic variables (sex and age), surgical variables (type and duration , extracorporeal circulation), and serum dosages of the markers of myocardial injury and inflammatory response. RESULTS: Of all patients, 12 (12.5%) met the clinical criteria for a diagnosis of postpericardiotomy syndrome, and their mean age was 10.3 years lower than the age of the others (P=0.02). The results of the serum markers for tissue injury and inflammatory response were not significantly different between the 2 assessed groups. No significant difference existed regarding either surgery duration or extracorporeal circulation. CONCLUSION: The patients who met the clinical criteria for postpericardiotomy syndrome were significantly younger than the others were. Serum markers for tissue injury and inflammatory response were not different in the clinically affected group, and did not correlate with the different types and duration of surgery or with extracorporeal circulation

Determinants of the postpericardiotomy syndrome: a systematic review

“…Köhler et al . found an association between younger age and PPS. This finding was confirmed by Miller et al .…”

“…After detailed screening on full‐text, 32 references were excluded from this review. The remaining 19 references were eligible for quality assessment .…”

“…After detailed screening on full-text, 32 references were excluded from this review. The remaining 19 references were eligible for quality assessment [2,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28].…”

“…Of the seven included studies, six studies investigated the association between clinical variables and PPS [2,11,12,14,17,18]. Results of these studies can be found in Table 4.…”

Post-cardiac injury syndrome

“…The syndrome is more frequently associated with younger age groups (age 47 ±20 on average) [4,5]. It occurs within a period of several days to several months after an operation or myocardial infarction.…”