Procalcitonin is useful whereas C-reactive protein is not, to predict complications following coronary artery bypass surgery

Macrina, Francesco; Tritapepe, Luigi; Pompei, Francesca; Sciangula, Alfonso; Evangelista, Ernesto; Toscano, Francesca; Criniti, Anna; Brancaccio, Gianluca; Puddu, Paolo Emilio
May 2005
Perfusion;May2005, Vol. 20 Issue 3, p169
Academic Journal
Background: The respective value of procalcitonin (PCT) and C-reactive protein (CRP) as markers of postoperative complications after coronary bypass surgery is unclear. Therefore, complications during one week after surgery were studied to evaluate the predictive role of PCT and CRP changes during the immediate postoperative period. Methods: Thirty-two patients, in whom an uneventful immediate postoperative course was anticipated, were prospectively enrolled and followed-up to the 7th postoperative day. At the end of the follow-up, patients were divided into two groups. Group A were patients with an uncomplicated postoperative course and Group B were patients with a complicated postoperative course. Results: Serum samples were drawn for PCT and CRP determination after induction of anesthesia (baseline), at the end of surgery and daily until postoperative day 2. Baseline serum PCT concentrations were 0.11±0.09 and 0.20±0.21 ng/mL in Groups A and B, respectively (NS). Serum PCT concentration increased compared with baseline in both groups during the first two days after surgery. The increase in serum PCT concentration was significantly greater in Group B than A patients (p <0.0002). Considering a perioperative abnormal cut-off value of >0.5 ng/mL, there were none in Group A versus 57% in Group B (p <0.0001). Baseline serum CRP concentrations were 1.44±1.30 and 1.58±1.35 ng/mL in Groups A and B, respectively (NS). After surgery, CRP increased significantly compared with baseline in both groups. When changes in time-varying variables were included in a logistic model, complications were predicted by changes (between baseline and end of surgery values) of PCT (coefficient=9.410; t=2.18) and heart rate (coefficient=0.075; t=1.57), whereas changes of CRP, white blood cells, mean blood and central venous pressures did not contribute statistically. The model constant was -4.827 (t=-2.43) and the ROC curve area was 0.8971. Thus, absolute PCT changes of 0.20, 0.40 and 0.60 ng/mL carry an approximate risk of 5, 26 and 69%, respectively, of postoperative complications in the time frame of this study. Conclusions: A postoperative serum PCT concentration of >0.5 ng/mL is highly suggestive of a postoperative complication. CRP changes do not contribute to predictive information.


Related Articles

  • Post-CABG complications create large economic cost.  // PharmacoEconomics & Outcomes News;6/28/2008, Issue 556, p7 

    The article discusses research on the relation of economic cost with major complications following coronary artery bypass graft (CABG) surgery. It references a study by Cardiac Data Solutions Inc., media release on June 17, 2008. Results show that complications are common and associated with...

  • Resultados de la revascularización miocárdica sin derivación cardiopulmonar en pacientes femeninas. Guzmán-González, Ricardo; Careaga-Reyna, Guillermo; Cardoza-Pacheco, Hugo; Argüero-Sánchez, Rubén // Cirugia y Cirujanos;ene/feb2008, Vol. 76 Issue 1, p29 

    Background: Women have more risk factors for coronary bypass graft surgery such as diabetes, high blood pressure, obesity, heart failure and shorter height (less body surface), compared with men. However, off-pump coronary artery bypass grafting demonstrates more benefits in females because it...

  • NT-pro-BNP, but not C-reactive protein, is predictive of atrial fibrillation in patients undergoing coronary artery bypass surgery Gasparovic, Hrvoje; Burcar, Ivan; Kopjar, Tomislav; Vojkovic, Jakov; Gabelica, Rajka; Biocina, Bojan; Jelic, Ivan // European Journal of Cardio-Thoracic Surgery;Jan2010, Vol. 37 Issue 1, p100 

    Abstract: Objective: Atrial fibrillation (AF) remains the most commonly observed complication following myocardial revascularisation surgery. We aimed to evaluate the clinical utility of N-terminal fragment of the brain natriuretic peptide (NT-pro-BNP), troponin T, transcoronary lactate gradient...

  • C-reactive protein as early predictor for infectious postoperative complications in rectal surgery. Welsch, T.; Müller, S. A.; Ulrich, A.; Kischlat, A.; Hinz, U.; Kienle, P.; Büchler, M. W.; Schmidt, J.; Schmied, B. M. // International Journal of Colorectal Disease;Dec2007, Vol. 22 Issue 12, p1499 

    This study evaluated the role of the acute phase C-reactive protein (CRP) in the postoperative course of a large series of rectal resections on the basis of a prospective database. Main focus of this study was the early identification of complications. Three hundred eighty-three rectal...

  • Plasma Prohepcidin as a Negative Acute Phase Reactant after Large Cardiac Surgery with a Deep Hypothermic Circulatory Arrest. Maruna, P.; Lindner, J.; Kunštýr, J.; Plocová, K.; Hubácek, J. // Physiological Research;2009, Vol. 58 Issue 6, p827 

    Hepcidin is a key regulator of iron metabolism and a mediator of anemia in inflammation. Recent in vitro studies recognized prohepcidin as a type II acute phase protein regulating via interleukin-6. The aim of the present study was to investigate the time course of plasma prohepcidin after a...

  • Comparative analysis of the results of minimally invasive myocardial revascularization and coronary artery bypass grafting on the beating heart and with artificial blood circulation. Ziankou, A. A.; Ostrovskij, U. P.; Vuhristenko, K. S.; Lojko, N. G. // Surgery News / Novosti Hirurgii;2014, Vol. 22 Issue 1, p33 

    Objectives. To carry out the comparative analysis of the immediate results of the minimally invasive myocardial revascularization (MIMR) and conventional coronary artery bypass surgery (CABS) on the beating heart and with artificial circulation (AC) for optimization of the surgical treatment of...

  • Factors associated to hypoxemia in patients undergoing coronary artery bypass grafting. dos Santos, Natália Pereira; Mitsunaga, Rodrigo Martins; Borges, Daniel Lago; de Albuquerque Gonçalves Costa, Marina; Pereira Baldez, Thiago Eduardo; Lima, Ilka Mendes; Fonseca Moura, Karol Cristina; da Silva Lula, Josimary Lima // Brazilian Journal of Cardiovascular Surgery;jul-sep2013, Vol. 28 Issue 3, p364 

    Introduction: Hypoxemia is a frequent pulmonary complication in the postoperative coronary artery bypass graft. Detection of factors associated with their occurrence may indicate patients at risk for this complication, which allows tracing specific therapeutic and consequently reduce morbidity...

  • Blood component utilization in cardiac revascularization in comparison of on-and off pump techniques in a tertiary care hospital of North India. Sonker, A.; Chaudhary, R.; Agarwal, S.; Pandey, S.; Khetan, D. // Asian Journal of Transfusion Science;Jul-Dec2007, Vol. 1 Issue 2, p97 

    Introduction: Cardiac revascularizations on a beating heart avoid the side effects of cardiopulmonary bypass (neurological injury and hemodilution and coagulopathy). We examined peri-operative use of blood components during coronary artery bypass grafting using either on-pump or off-pump...

  • Choice of conduits for coronary artery bypass grafting: craft or science? Buxton, Brian F.; Hayward, Philip A.R.; Newcomb, Andrew E.; Moten, Simon; Seevanayagam, Siven; Gordon, Ian // European Journal of Cardio-Thoracic Surgery;Apr2009, Vol. 35 Issue 4, p658 

    Summary: Long-term patency of a bypass graft is an important determinant in reducing morbidity and increasing survival after coronary bypass surgery. The purpose of this review is to analyse factors contributing to improved outcomes of commonly used conduits. Progress has been limited by the...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics