title: C-Reactive protein and inflammatory response associated to neurocognitive decline following cardiac surgery.
abstract: BACKGROUND
  It has been recognized that neurocognitive decline (NCD) often occurs as a complication in cardiac surgery. The early inflammatory response and C-reactive protein (CRP) was examined in relation to NCD and to a marker of axonal central nervous system (CNS) injury after cardiopulmonary bypass.
  
  
  METHODS
  A cohort of patients undergoing coronary artery bypass grafting and/or valve procedures using cardiopulmonary bypass were administered a neurocognitive battery preoperatively and postoperatively at 6 hours and day 4. CRP, interleukin 1 beta, and interleukin 10 were quantified from serum. Increase of serum tau protein after surgery was used as a marker of axonal CNS damage.
  
  
  RESULTS
  The rate of NCD was found to be 40.5% in this group. Surprisingly, known predictors of NCD did not differ significantly between patients with/without NCD. Patients with NCD had an early increase of CRP of a significantly higher magnitude than those without NCD (38.01 +/- 11.4 vs 16.49 +/- 3.5 mg/L, P = .042), interleukin 1ss (2.35 +/- 0.3 vs 1.20 +/- 0.2 pg/mL, P = .002), and interleukin 10 (29.77 +/- 4.7 vs 12.94 +/- 2.2 pg/mL, P < .001). Increase in serum Tau protein was significantly correlated to NCD (r = 0.50, P = .02).
  
  
  CONCLUSIONS
  Perioperative increases in CRP and inflammatory cytokines are associated with NCD in patients after cardiopulmonary bypass. Thus, it appears that inflammation plays a key role in NCD pathophysiology, likely via axonal CNS injury, and could become a target for prevention.
authors.affiliation: Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
authors.forename: Basel
authors.initials: B
authors.lastname: Ramlawi
authors.forename: James L
authors.initials: JL
authors.lastname: Rudolph
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Mieno
authors.forename: Jun
authors.initials: J
authors.lastname: Feng
authors.forename: Munir
authors.initials: M
authors.lastname: Boodhwani
authors.forename: Kamal
authors.initials: K
authors.lastname: Khabbaz
authors.forename: Sue E
authors.initials: SE
authors.lastname: Levkoff
authors.forename: Edward R
authors.initials: ER
authors.lastname: Marcantonio
authors.forename: Cesario
authors.initials: C
authors.lastname: Bianchi
authors.forename: Frank W
authors.initials: FW
authors.lastname: Sellke
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D003072:Cognition Disorders / Q000097:blood* / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D008297:Male; D008875:Middle Aged; D016875:tau Proteins / Q000097:blood
chemical_list: D007375:Interleukin-1; D016875:tau Proteins; D016753:Interleukin-10; D002097:C-Reactive Protein