Changes in Interleukin-6 and Highly Sensitive C-Reactive Protein in Patients who Underwent Redo Coronary Artery Bypass Grafting

Abstract

Background: Determination of biomarkers can assess cardiac injury induced by cardiopulmonary bypass (CPB) during coronary artery bypass grafting (CABG). Open heart surgery initiates inflammatory reaction. Aim of this study was to compare the inflammatory response in patients undergoing first-and CABG-reoperation. Methods: Fifty-four patients (16% female, 84% male; 60.5 ± 6.5 vs. 66.2 ± 7.3 years) scheduled for elective cardiac surgery were divided into: Group 1, CABG primo-operation, and Group 2, CABG re-operation (redo CABG). The extent of inflammation was estimated by measuring interleukin (IL)-6 and highly sensitive C-reactive protein (hs-CRP) in plasma. Blood samples were collected: 24 hours prior, 6, and 24 hours after initiation of CPB. Demographic data, preoperative risk assessment Euro-score, laboratory values and clinical outcomes: atrial fibrillation rate, tracheal intubation time, revisions, blood loss, length of Intensive Care Unit (ICU) and hospital stay were analyzed. Results: Baseline levels of IL-6 (p < 0.001) were significantly higher in re-operated patients. IL-6 increased significantly 6 hours after initiation of CPB in both groups (p < 0.0001). Day after surgery IL-6 (p = 0.472) and hs-CRP (p = 0.248) levels were similar in both groups. Although hs-CRP was higher in Group 1 (90.45 ± 46.67 vs. 72.91 ± 57.31 mg/L) this had no statistical significance. Clinical outcomes have been in positive correlations with inflammation, but statistically insignificant in both groups. Conclusion: Monitoring of IL-6 and hs-CRP during redo CABG has shown that CPB cause inflammatory reaction but repeated use does not cause extensive reaction potentially harmful for myocardium.

Effect of protective lung ventilation during cardiopulmonary bypass on serum procalcitonin and interleukin- 6 concentrations in coronary artery bypass grafting patients

“…10 Theo Branislav và cộng sự, nồng độ IL-6 của bệnh nhân phẫu thuật bắc cầu chủ vành có THNCT ở thời điểm 6 giờ và 24 giờ sau phẫu thuật lần lượt là 253,35 ± 158,525 và 247, 369 (196,229 -311,836) pg/ml. 14 Có thể sự khác biệt về chủng tộc và số lượng bệnh nhân đã làm cho giá trị của IL-6 khác biệt giữa các nghiên cứu.…”

A new weapon in the fight against postcardiac surgery muscle catabolism

“…1 This proinflammatory milieu is characterized by perioperative increased plasma levels of cytokines such as interleukin 6 and tumor necrosis factor alpha and contributes to the establishment of a catabolic phase that occurs during the postoperative course. 2,3 The subsequent muscle wasting and muscle weakness appears early in critically ill patients, negatively influencing outcomes. [4][5][6] In this scenario, patient-related factors, such as preoperative nutritional status, body mass index, hemoglobin level, and endocrine alterations interact with procedure-related determinants.…”