Hyperprocalcitonemia in patients with perioperative myocardial infarction after cardiac surgery.
OBJECTIVE
To describe and compare procalcitonin (PCT) concentrations after cardiac surgery in uncomplicated patients and in patients with perioperative myocardial infarction (PMI).


METHODS
Retrospective comparative study.


METHODS
One university hospital.


METHODS
Fifty-eight adult patients undergoing cardiac surgery.


METHODS
None.


RESULTS
In a first step, plasma PCT and C-reactive protein concentrations were measured preoperatively and until 72 hrs postoperatively in ten consecutive patients who underwent uncomplicated cardiac surgery. PCT concentrations increased progressively from the end of cardiopulmonary bypass (0.09 +/- 0.09 ng/mL), peaked at 24 hrs postoperatively (1.14 +/- 1.24 ng/mL), and began to decrease at 48 hrs. C-reactive protein appeared to peak at 48 hrs (from 5.8 +/- 11.7 mg/L preoperatively to 265.1 +/- 103.5 mg/L on the second postoperative day). In a second step, PCT concentrations were measured at day one in 23 patients (PMI group) who presented high postoperative plasma cardiac troponin I concentrations and were compared with PCT concentrations observed in 25 matched uncomplicated patients. All patients were free from infection. PCT in the PMI group was significantly higher than in the control group (27.1 +/- 63.2 vs. 2.0 +/- 2.4 ng/mL, respectively; p =.0053).


CONCLUSIONS
Because high plasma concentrations of PCT were found in patients with PMI after cardiac surgery, it may be suggested that, in the early postoperative period, elevated plasma PCT concentrations should be interpreted with caution regarding infection diagnosis.
Service d'Anesthésiologie et Réanimation Chirurgicale, Hôpital Bichat-Claude Bernard, Paris, France.
J B
JB
Lecharny
D
D
Khater
R
R
Bronchard
I
I
Philip
G
G
Durand
J M
JM
Desmonts
M
M
Dehoux
D000328:Adult; D001424:Bacterial Infections / Q000097:blood / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D007249:Inflammation; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000209:etiology*; D009336:Necrosis; D011237:Predictive Value of Tests; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D012189:Retrospective Studies; D013997:Time Factors; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D019210:Troponin I; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide