title: Growth factors serum levels in coronary artery disease patients scheduled for bypass surgery: perioperative dynamics and comparisons with healthy volunteers.
abstract: BACKGROUND
  Vascular endothelial growth factors are important mediators for neovascularization of chronically ischemic adult heart, but their elevated values have also been connected with acute ischemia. Coronary artery bypass grafting (CABG) is associated with activation of inflammatory processes. We aimed to clarify whether the latter is also accompanied with acute changes in concentrations of vascular growth factors.
  
  
  METHODS
  Concentrations of growth factors VEGF and EGF, monocyte chemoattractant protein-1 (MCP-1), and a set of cytokines of 39 patients with stable coronary artery disease (CAD) were evaluated before and after CABG. Preoperative values were compared with data of healthy volunteers.
  
  
  RESULTS
  In comparison with CAD patients, healthy controls had significantly higher values of VEGF (15.5 (10.05-35.3) and 119.4 (55.7-136.9) pg/mL, resp.), EGF (1.70 (1.14-3.18) and 37.3 (27.1-51.9) pg/mL, resp.), and MCP-1 (111.6 (81.75-171.9) and 156.9 (134.7-241.3) pg/mL, resp.). MCP-1, but not others, demonstrated a significant rise throughout the postoperative period. Proinflammatory interleukin-6 was significantly higher and anti-inflammatory IL-4 and IL-10 lower in patients with CAD.
  
  
  CONCLUSIONS
  Patients with stable CAD have lower serum levels of growth factors than healthy volunteers. MCP-1, but not VEGF and EGF, becomes elevated immediately after CABG. Inflammatory status of CAD patients was drifted towards proinflammatory state.
authors.affiliation: North Estonia Medical Centre, Clinic of Anaesthesiology, Sütiste 19, 13419 Tallinn, Estonia. inga.karu@regionaalhaigla.ee
authors.forename: Inga
authors.initials: I
authors.lastname: Karu
authors.forename: Joel
authors.initials: J
authors.lastname: Starkopf
authors.forename: Kersti
authors.initials: K
authors.lastname: Zilmer
authors.forename: Mihkel
authors.initials: M
authors.lastname: Zilmer
mesh_terms: D000328:Adult; D018932:Chemokine CCL2 / Q000097:blood; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000097:blood* / Q000601:surgery*; D016207:Cytokines / Q000097:blood; D004815:Epidermal Growth Factor / Q000097:blood; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; D016207:Cytokines; D036341:Intercellular Signaling Peptides and Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D004815:Epidermal Growth Factor