Role of Neopterin, C-Reactive Protein and Myeloperoxidase in Patients Undergoing Cardiopulmonary Bypass

Ayaz, Lokman; Ünlü, Ali; Sucu, Nehir; Tamer, Lülüfer; Atik, Uğur; Sungur, Mehmet Alı

doi:10.1159/000320308

Cited by 10 publications

(4 citation statements)

References 53 publications

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“…In the present study, we found no correlation between CRP and neopterin levels in elective cardiac surgery patients, although CRP levels were significantly higher in elective cardiac surgery patients than in acutely ill medical patients. A previous study, performed in patients who underwent CABG, showed that both CRP and neopterin levels increased after on-pump CABG, but the increase was significantly greater for CRP than for neopterin 34. This finding suggests a poor correlation between CRP and neopterin after on-pump CABG, which is in line with our findings.…”

Section: Discussionsupporting

confidence: 90%

<p>Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients</p>

Egberts¹,

Osse²,

Fekkes³

et al. 2019

CIA

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Background/aimsThe pathophysiology of delirium is poorly understood. Increasing evidence suggests that different pathways might be involved in the pathophysiology depending on the population studied. The aim of the present study was to investigate potential differences in mean plasma levels of neopterin, amino acids, amino acid ratios and homovanillic acid between two groups of patients with delirium.MethodsData from acutely ill medical patients aged 65 years and older, and patients aged 70 years and older undergoing elective cardiac surgery, were used. Differences in biomarker levels between the groups were investigated using univariate ANOVA with adjustments for age, sex, comorbidities, C-reactive protein (CRP) and the estimated glomerular filtration rate (eGFR), where appropriate. Linear regression analysis was used to identify potential determinants of the investigated biochemical markers.ResultsEighty patients with delirium were included (23 acutely ill medical patients and 57 elective cardiac surgery patients). After adjustment, higher mean neopterin levels (93.1 vs 47.3 nmol/L, P=0.001) and higher phenylalanine/tyrosine ratios (1.39 vs 1.15, P=0.032) were found in acutely ill medical patients when compared to elective cardiac surgery patients. CRP levels were positively correlated with neopterin levels in acutely ill medical patients, explaining 28.4% of the variance in neopterin levels. eGFR was negatively correlated with neopterin in elective cardiac surgery patients, explaining 53.7% of the variance in neopterin levels.ConclusionIn this study, we found differences in mean neopterin levels and phenylalanine/tyrosine ratios between acutely ill medical and elective cardiac surgery patients with delirium. Moreover, our findings may suggest that in acutely ill medical patients, neopterin levels are mainly determined by inflammation/oxidative stress whereas in elective cardiac surgery patients, neopterin levels are mainly driven by renal function/fluid status. These findings suggest that the markers and pathways that might be involved in the pathophysiology of delirium may differ between specific groups of patients.

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Section: Discussionsupporting

confidence: 90%

<p>Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients</p>

Egberts¹,

Osse²,

Fekkes³

et al. 2019

CIA

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“…These results are consistent with previous animal and human studies in which penehyclidine hydrochloride or dexmedetomidine had an effect on in ammatory factors such as IL-6 and TNF-α [18,38] . At 6 h after CPB, the concentration of CRP in the four groups began to increase, which was more obvious at 24 h after CPB than preoperatively, which was similar to the typical change trend of CRP after cardiopulmonary bypass [39] . Previous studies found that penehyclidine hydrochloride reduced high-sensitivity CRP in patients with acute ischemia/reperfusion injury after cardiopulmonary resuscitation [40] .…”

Section: Discussionsupporting

confidence: 66%

Effects of penehyclidine hydrochloride combined with dexmedetomidine on pulmonary function in patients undergoing heart valve surgery: A Double-Blind, Randomized Trial

et al. 2023

Preprint

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Aim: To investigate the effects of penehyclidine hydrochloride combined with dexmedetomidine on pulmonary function in patients undergoing heart valve surgery with cardiopulmonary bypass (CPB). Methods: A total of 180 patients undergoing elective heart valve surgery with CPB were randomly divided into four groups: 45 in group P (intravenous penehyclidine hydrochloride 0.02 mg/kg 10 min before anesthesia induction and at the beginning of CPB, total 0.04 mg/kg); 43 in group D (dexmedetomidine 0.5 μg/kg/h after induction of anesthesia until the end of anesthesia); 44 in group PD ( penehyclidine hydrochloride 0.04 mg/kg combined with dexmedetomidine 0.5 μg/kg/h intravenously during anesthesia); and 43 in group C (same amount of normal saline 10 min before and after anesthesia induction, to the end of anesthesia, and at the beginning of CPB). The main outcomes were the incidence and severity of postoperative pulmonary complications (PPCs). The secondary outcomes were: (1) extubation time, length of stay in intensive care, and postoperative hospital stay, and adverse events; and (2) pulmonary function evaluation indexes (oxygenation index and respiratory index) and plasma inflammatory factor concentrations (tumor necrosis factor-α, interleukin-6, C-reactive protein and procalcitonin) during the perioperative period. Results: The incidence of PPCs in groups P, D and PD after CPB was lower than that in group C (P < 0.05), and the incidence in group PD was significantly lower than that in groups P and D (P < 0.05). The scores for PPCs in groups P, D and PD were lower than those in group C (P < 0.05). Conclusion: Combined use of penehyclidine hydrochloride and dexmedetomidine during anesthesia reduced the occurrence of postoperative pulmonary dysfunction, and improved the prognosis of patients undergoing heart valve surgery with CPB. Trial registration: The trial was registered in the Chinese Clinical Trial Registry on 3/11/2020 (Registration No.: ChiCTR2000039610).

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“…This could be related to the inflammatory response mediated by advancing age through a variety of molecular mechanisms such as the mitochondrial adaptor protein p66 (Shc) and the family of deacetylase enzymes, the sirtuins [16] . In addition to the normal ageing process, cardiac surgery itself induces a systemic inflammatory response [17] . A previous study reported higher serum resistin levels both in the pre-and postoperative phases along with other proinflammatory markers (IL-6, IL-10, and CRP) [18] .…”

Section: Discussionmentioning

confidence: 99%

Association of Preoperative Platelet-to-Lymphocyte Ratio with Atrial Fibrillation after Coronary Artery Bypass Graft Surgery

Güngör¹,

Babu

Zencir³

et al. 2016

Med Princ Pract

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Objective: The aim of this study was to investigate the association between platelet-to-lymphocyte ratio (PLR) and atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery. Subjects and Methods: A total of 125 patients were retrospectively analyzed. AF was diagnosed using standard clinical criteria, and PLR was calculated as the ratio of the platelets to lymphocytes, obtained from the blood samples that were taken in the fasting state before CABG surgery. The association of different variables with postoperative AF and PLR was calculated using univariate and multivariate analysis. The receiver operating characteristics curve was used to determine the sensitivity and specificity of PLR and the optimal cutoff value for predicting post-CABG AF. Results: Of the 125 patients, 50 with AF (mean age: 67.0 ± 9.5 years, 38 males and 12 females) and 75 patients without AF (mean age: 61.1 ± 9.1 years, 58 males and 17 females) were identified, and the difference in the mean age was statistically significant (p = 0.01). PLR was also significantly higher in those with AF (152.8 ± 82.2) than those without AF (118.2 ± 32.9) (p = 0.012). Univariate analysis showed that age and PLR were associated with AF after CABG surgery (p < 0.001 and p = 0.005, respectively). Using a multivariate logistic regression model with the backward elimination method, age and PLR remained as independent predictors of AF after CABG surgery (p < 0.001 and p = 0.005, respectively). PLR levels >119.3 predicted postoperative AF with 64% sensitivity and 56% specificity (AUC: 0.634, p = 0.012). Conclusion: In this study, age and PLR level were independent predictors of AF after CABG surgery. Patients with an elevated preoperative PLR were at higher risk of AF after CABG surgery.

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Role of Neopterin, C-Reactive Protein and Myeloperoxidase in Patients Undergoing Cardiopulmonary Bypass

Cited by 10 publications

References 53 publications

<p>Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients</p>

<p>Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients</p>

Effects of penehyclidine hydrochloride combined with dexmedetomidine on pulmonary function in patients undergoing heart valve surgery: A Double-Blind, Randomized Trial

Association of Preoperative Platelet-to-Lymphocyte Ratio with Atrial Fibrillation after Coronary Artery Bypass Graft Surgery

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