title: Unchanged plasma levels of the soluble urokinase plasminogen activator receptor in elective coronary artery bypass graft surgery patients and cardiopulmonary bypass use.
abstract: OBJECTIVE
  The soluble urokinase plasminogen activator receptor (suPAR) has been recently recognized as a potential biological marker of various disease states, but the impact of a major surgical intervention on the suPAR level has not yet been established. The aim of our study was to investigate if the induction of a systemic inflammatory reaction in response to cardiopulmonary bypass would be accompanied by an increase in the plasma suPAR level.
  
  
  METHODS
  Patients undergoing coronary artery bypass grafting under cardiopulmonary bypass (CPB) were added. Based on the baseline suPAR level, patients were divided into group 1 (suPAR within normal range) or group 2 (suPAR above range). Blood was collected before the induction of anesthesia and 6 and 24 hours after surgery. Plasma suPAR, IL-6, IL-8, TNF-α, troponin I, NT-proBNP, and NGAL were quantified to assess the impact of surgical trauma on these markers.
  
  
  RESULTS
  The baseline suPAR level was within the normal range in 31 patients (3.3 ng/mL), and elevated in 29 (5.1 ng/mL) (p<0.001). Baseline mediators of systemic inflammatory reaction concentrations (IL-6, TNF-α, and IL-8) and organ injury indices (troponin I, NT-proBNP, and NGAL) were low and increased after surgery in all patients (p<0.05). The surgery did not cause significant changes in the suPAR level either at 6 or 24 hours after, however the difference between groups observed at baseline remained substantial during the postoperative period.
  
  
  CONCLUSIONS
  There was no change in the suPAR level observed in patients subjected to elective cardiac coronary artery bypass surgery and CPB, despite activation of a systemic inflammatory reaction.
authors.affiliation: Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Gozdzik
authors.affiliation: Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Adamik
authors.affiliation: Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Gozdzik
authors.affiliation: Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Rachwalik
authors.affiliation: Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Kustrzycki
authors.affiliation: Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kübler
mesh_terms: D015415:Biomarkers / Q000097:blood / Q000737:chemistry; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood* / Q000737:chemistry*; D012995:Solubility
chemical_list: D015415:Biomarkers; D055293:Receptors, Urokinase Plasminogen Activator