ANAESTHESIOLOGY AND INTENSIVE CARE Prognostic value of sCD14-ST (presepsin) in cardiac surgery

Abstract

IntroductionPrediction of complications and mortality after cardiac surgery is an important aspect of timely correction of these conditions. One possibility in this case is the use of biomarkers and some prognostic scores.Aim of the studyTo study the prognostic value of presepsin (PSP) as a predictor of postoperative complications development in cardiosurgical patients.Material and methodsPatients operated for acquired heart diseases with cardiopulmonary bypass (CPB) were included in the study (n = 51, age: 58 ± 11 years). Besides routine clinical and laboratory data, PSP and procalcitonin (PCT) levels were monitored perioperatively (before surgery, and on the 1st, 2nd, 3rd and 6th day after surgery).ResultsThere were no clinical signs of infection before surgery in any of the studied patients. We found supranormal PSP levels in 6 patients (11.8%) before operations (543 [519-602] pg/ml, max 1597 pg/ml; normal value: 365 pg/ml). Infectious complications developed in 19 patients (37%). Statistically significant differences in PSP levels, APACHE II (Acute Physiology and Chronic Health Evaluation II) and SOFA (Sequential Organ Failure Assessment) scores in groups of patients with and without infection were documented from the 1st and in PCT from the 2nd day after the operation. The cut-off values were 702 pg/ml, 8.5 points, 7.5 points and 3.3 ng/ml, respectively. Hospital mortality was 13.7% (7 patients); all cases of death were in the group of patients with infectious complications. Statistically significant differences in PCT levels, APACHE II and SOFA scores between the groups with favorable and lethal outcomes were observed from the first postoperative day. The same for PSP levels was documented only on the 3rd postoperative day. The cut-off values were 7.42 ng/ml, 11 points, 8.5 points and 683 pg/ml, respectively.ConclusionThe use of modern biomarkers alongside integral severity-of-disease scores allows prediction of the risk of infectious complications and mortality in cardiosurgical patients.

Prognostic value of presepsin (soluble CD14-subtype) in diagnosis of ventilator-associated pneumonia and sepsis in trauma patients

“…In our study levels of presepsin were significantly higher in patients who developed VAP compared to those with SIRS and significantly higher in patients with sepsis compared to those with VAP or SIRS. These results are in line with few studies that measured levels of sCD14-ST in blood samples for local infection diagnosis [21][22][23] . In study of Shozushima et al 22 presepsin levels were significantly higher in patients with local infection, sepsis, and severe sepsis than in patients without infection.…”

“…In study of Shozushima et al 22 presepsin levels were significantly higher in patients with local infection, sepsis, and severe sepsis than in patients without infection. Similarly, Popov et al 23 showed significantly higher values of presepsin in the group of patient with infectious complications than in those without infections following cardiac surgery. In our study, however, we measured biomarkers levels only after the clinical diagnosis of infection was made.…”

Presepsin and Procalcitonin Levels as Markers of Adverse Postoperative Complications and Mortality in Cardiac Surgery Patients

“…Reiner et al [3] demonstrated a strong association between the precursor of presepsin and the incidence of cardiovascular disease in the elderly. Additionally, Popov et al [23] recently analyzed the prognostic value of presepsin as a predictor of postoperative complications in patients having surgery for acquired heart disease. In particular, heart failure was strongly associated with increased levels of the biomarker.…”

Serum Presepsin Levels in Patients with Decompensated Heart Failure

“…Similarly, Popov et al evaluated the prognostic value of PSP in patients operated for acquired heart diseases and revealed that PSP levels were increased in patients with acute HF and acute coronary syndrome without infection. (22) In our study, median PSP level was 684 pg / mL ranging from 147 to 5529 pg / mL in the patient group. Liu et al declared median PSP levels as 787 pg / mL for severe sepsis and 1084 pg / mL for septic shock in an emergency department.…”