Inflammatory/oxidative stress during the first week after different types of cardiac surgery.
OBJECTIVE
To compare inflammatory and oxidative stress time course during the first week after different types of cardiac surgery.


METHODS
In patients undergoing coronary artery bypass grafting with cardiopulmonary bypass (CABG) or on the working heart (OPCAB) and aortic valve replacement (VALVE) blood samples for high-sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), myeloperoxidase (MPO), asymmetric dimethylarginine (ADMA) and homocysteine (Hcy) were taken preoperatively and for six consecutive postoperative days.


RESULTS
Exploitation of cardiopulmonary bypass (CABG, VALVE groups), but not OPCAB, resulted in significant rise of MPO for two postoperative days. ADMA and Hcy changed in parallel fashion, being significantly decreased in the first postoperative morning and rising to the preoperative levels thereafter. In comparison with coronary artery disease patients, VALVE group had lower preoperative levels of ADMA and different postoperative time course. Postoperative concentrations of IL-6 and hsCRP were increased significantly in all groups and remained elevated during the first postoperative week.


CONCLUSIONS
Cardiac surgery results in extensive and complex inflammatory/oxidative stress response regardless of the method or type of surgical procedure used. Myeloperoxidase could be one of the parameters to evaluate the cardiopulmonary bypass-associated inflammatory and oxidative stress response.
North Estonia Medical Centre, Clinic of Anesthesiology, Tallinn, Estonia. inga.karu@regionaalhaigla.ee
Inga
I
Karu
Günter
G
Taal
Kersti
K
Zilmer
Chris
C
Pruunsild
Joel
J
Starkopf
Mihkel
M
Zilmer
D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000209:etiology* / Q000276:immunology; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D009195:Peroxidase / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D006710:Homocysteine; C018524:N,N-dimethylarginine; D002097:C-Reactive Protein; D001120:Arginine; D009195:Peroxidase