CRP, IL-6 and endothelin-1 levels in patients undergoing coronary artery bypass grafting. Do preoperative inflammatory parameters predict early graft occlusion and late cardiovascular events?

Hedman, Anders; Larsson, P. T.; Alam, Mahbubul; Wallén, N H; Nordlander, Rolf; Samad, Bassem A.

doi:10.1016/j.ijcard.2006.09.004

Cited by 40 publications

(33 citation statements)

References 51 publications

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“…level with an increased overall incidence of infection and sepsis, short-and long-term postoperative mortality, and early graft occlusion has been demonstrated by previous studies. 3,12,14,22 In contrast, a preoperative level of CRP as high as >5 mg/L could not predict in-hospital postoperative complications following primary isolated on-pump CABG. 4 In a prospective study, Tn-T but not CRP was identified as a predictive variable for short-term prognosis following onpump CABG and those authors suggested that myocardial ischemia plays the main role in on-pump CABG, in contrast with PCI where inflammation is the cornerstone.…”

Section: Discussionmentioning

confidence: 87%

Predictive Value of C-Reactive Protein for Major Postoperative Complications Following Off-Pump Coronary Artery Bypass Surgery Prospective and Observational Trial

Kim

Shim

Hong

et al. 2009

Circ J

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Background: To prospectively investigate the predictive value of the preoperative C-reactive protein (CRP) concentration for major postoperative complications following off-pump coronary artery bypass (OPCAB) surgery. Methods and Results: From January 2007 to December 2007, 185 consecutive patients scheduled for elective OPCAB surgery were allocated to a low-CRP group (n=137, CRP <0.3 mg/dl) and a high-CRP group (n=48, CRP ≥0.3 mg/dl). The incidence of major postoperative complications, defined as postoperative myocardial infarction, and 5 major morbidity endpoints including permanent stroke, renal dysfunction, any cardiac surgery reoperation, ventilation for more than 48 h, and deep sternal wound infection were assessed and compared. Multivariate logistic regression was used to determine the predictors of major postoperative complications. Patients in the high-CRP group had a significantly higher overall incidence of major postoperative complications, particularly renal dysfunction. In the multivariate logistic regression model, adjusting all the significant univariate predictors, baseline CRP >0.3 mg/dl and preoperative chronic renal failure (CRF) remained as significant independent predictors of major postoperative complications. Conclusions: Elevated preoperative CRP level and/or preoperative CRF indicate increased risk of developing major postoperative complications, particularly acute postoperative renal dysfunction in patients undergoing OPCAB surgery. (Circ J 2009; 73: 872 -877)

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Section: Discussionmentioning

confidence: 87%

Predictive Value of C-Reactive Protein for Major Postoperative Complications Following Off-Pump Coronary Artery Bypass Surgery Prospective and Observational Trial

Kim

Shim

Hong

et al. 2009

Circ J

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“…Variation in inflammatory responses between individuals can have considerable effects on disease outcomes for a number of conditions, and such variation may play a role in the outcomes of cardiac surgery (36,37 ), in which IL-6 concentrations remain high in patients with postoperative complications. Indeed, preoperative IL-6 concentrations can act as a prognostic marker for postoperative complications (data not shown).…”

Section: Il-6 Association With Il6 ؊6331t>c Snpmentioning

confidence: 99%

Association of Serum Interleukin-6 Concentration with a Functional IL6 −6331T>C Polymorphism

et al. 2008

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Background: Interleukin-6 (IL-6) concentrations vary substantially among individuals. This study aimed to identify novel genetic markers to explain these differences. Methods: We sequenced a region 6-kb upstream of the IL6 [interleukin 6 (interferon, beta 2)] transcription start site in a search for functional variants and detected 3 common variants: −6331T>C, −6101A>T, and −5617/−5616C/A>T/G. IL6 −6331T>C (C allele frequency, 0.20; 95% confidence interval, 0.16–0.24) showed strong negative linkage disequilibrium with −174G>C (D′ = −0.97) and was studied further in 309 individuals who underwent coronary artery bypass grafting. Results: Patients with the TT genotype had higher IL-6 concentrations 6 h after surgery than those with the CC genotype (mean, 199.4 ng/L vs 114.9 ng/L; P = 0.02). A similar association was seen in a cohort of 173 patients who underwent intensive periodontal therapy: Individuals with the CC genotype had significantly lower IL-6 concentrations 24 h after therapy than TT patients (mean, 0.78 ng/L vs 5.00 ng/L; P < 0.0001). A similar trend was observed in 203 healthy individuals from northern Europe (1.29 ng/L for the TT genotype vs 0.89 ng/L for the CC genotype; P = 0.07). Reporter assays that used a sequence flanking the −6331 single-nucleotide polymorphism spliced upstream to the IL-6 minimal promoter driving luciferase gene expression demonstrated a 1.3-fold increase in promoter activity (P < 0.01) for constructs containing −6331T. Electrophoretic mobility shift assays revealed enhanced binding of transcription factor Oct-1 to the T allele. Conclusions: IL6 −6331T is associated with increased IL-6 concentrations in an acute inflammatory state via a mechanism involving binding of the Oct-1 transcription factor. This finding may help resolve conflicting studies based on the IL6 −174G>C variant.

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“…In this study we therefore first sought to investigate whether exogenous ET-1 increases ROS production in human vessels from patients with CAD. ET-1 produced a significant increase in O 2 − production with a clear effect at 10 − 10 M. This concentration of ET-1 is considerably lower than those in previously presented studies on ET-induced O 2 − production (Duerrschmidt et al, 2000;Ergul et al, 2005;Loomis et al, 2005;Touyz et al, 2004) which have used concentrations ranging from 10 − 6 to 10 − 9 M. Several studies have shown that patients with CAD have increased levels of circulating ET-1 (Hedman et al, 2007;Sabatine et al, 2012;Yip et al, 2005). These levels are usually in picomolar range and its biological effect is unclear since secretion of ET-1 predominantly occurs abluminally.…”

Section: Discussionmentioning

confidence: 66%

Endothelin-1 increases superoxide production in human coronary artery bypass grafts

et al. 2012

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ET-1 increases O(2)(-) production especially in human arteries and less so in veins from patients with coronary artery disease via a receptor-dependent pathway involving a flavin dependent enzyme which is likely to be NADPH oxidase. Production of O(2)(-) may be an important factor underlying the negative effects of ET-1 on vascular function such as impairment of endothelium-dependent vasodilatation and pro-inflammatory effects.

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CRP, IL-6 and endothelin-1 levels in patients undergoing coronary artery bypass grafting. Do preoperative inflammatory parameters predict early graft occlusion and late cardiovascular events?

Cited by 40 publications

References 51 publications

Predictive Value of C-Reactive Protein for Major Postoperative Complications Following Off-Pump Coronary Artery Bypass Surgery Prospective and Observational Trial

Predictive Value of C-Reactive Protein for Major Postoperative Complications Following Off-Pump Coronary Artery Bypass Surgery Prospective and Observational Trial

Association of Serum Interleukin-6 Concentration with a Functional IL6 −6331T>C Polymorphism

Endothelin-1 increases superoxide production in human coronary artery bypass grafts

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CRP, IL-6 and endothelin-1 levels in patients undergoing coronary artery bypass grafting. Do preoperative inflammatory parameters predict early graft occlusion and late cardiovascular events?

Cited by 40 publications

References 51 publications

Predictive Value of C-Reactive Protein for Major Postoperative Complications Following Off-Pump Coronary Artery Bypass Surgery Prospective and Observational Trial

Predictive Value of C-Reactive Protein for Major Postoperative Complications Following Off-Pump Coronary Artery Bypass Surgery Prospective and Observational Trial

Association of Serum Interleukin-6 Concentration with a Functional IL6 −6331T&gt;C Polymorphism

Endothelin-1 increases superoxide production in human coronary artery bypass grafts

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Association of Serum Interleukin-6 Concentration with a Functional IL6 −6331T>C Polymorphism