Associations of Inflammatory Biomarkers With the Risk of Morbidity and Mortality After Cardiac Surgery: A Systematic Review and Meta-analysis

Heo, Rachel; Wang, Michael Ke; Meyre, Pascal; Birchenough, Lauren; Park, Louis; Vuong, Kiven; Devereaux, P.J.; Blum, Steffen; Lindahl, Bertil; Stone, Gregg W.; Conen, David

doi:10.1016/j.cjca.2023.07.021

Cited by 7 publications

(4 citation statements)

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“…The inflammatory process is a physiological response to trauma and is inherent in all surgical procedures ( 1 - 5 ). However, in major surgeries, such as those involving cardiopulmonary bypass (CPB), the inflammatory response can become pathological and lead to postoperative complications due to the blood’s contact with a non-endothelial surface ( 6 - 9 ).…”

Section: Introductionmentioning

confidence: 99%

Myocardial tissue expression of mRNA and preoperative neutrophil-lymphocyte ratio in children undergoing congenital heart surgery

Manuel,

Miana,

Fonseca-Alaniz

et al. 2024

Transl Pediatr

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Background The neutrophil-lymphocyte ratio (NLR) is an easily accessible and inexpensive biomarker that has been shown to predict morbidity and mortality in congenital cardiac surgery. However, its regulatory mechanism remains unclear. This study aims to compare and correlate the tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, IL-6, and IL-10 messenger RNAs (mRNAs) with the NLR in patients with tetralogy of Fallot (ToF) and ventricular septal defect (VSD). Methods A prospective translational study was conducted on 10 children with ToF and 10 with VSD, aged between 1 and 24 months. The NLR was calculated from the blood count taken 24 hours before surgery. The expression of these mRNAs was analyzed in the myocardial tissue of the right atrium prior to cardiopulmonary bypass. Results Patients with ToF exhibited a higher NLR [ToF 0.46 (interquartile range; IQR) 0.90; VSD 0.28 (IQR 0.17); P=0.02], longer mechanical ventilation time [ToF 24 h (IQR 93); VSD 5.5 h (IQR 8); P<0.001], increased use of vasoactive drugs [ToF 2 days (IQR 1.75); VSD 0 (IQR 1); P=0.01], and longer ICU [ToF 5.5 (IQR 1); VSD 2 (IQR 0.75); P=0.02] and hospital length of stays [ToF 18 days (IQR 17.5); VSD 8.5 days (IQR 2.5); P<0.001]. A negative correlation was found between NLR and oxygen saturation (SaO 2 ) (r=−0.44; P=0.002). In terms of mRNA expression, the ToF group showed a lower expression of IL-10 mRNA (P=0.03). A positive correlation was observed between IL-10-mRNA and SaO 2 (r=0.40; P=0.07), and a negative correlation with NLR (r=−0.27; P=0.14). Conclusions Patients with ToF demonstrated a higher preoperative NLR and lower IL-10 mRNA expression by what appears to be a pro-inflammatory phenotype of cyanotic patients.

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Section: Introductionmentioning

confidence: 99%

Myocardial tissue expression of mRNA and preoperative neutrophil-lymphocyte ratio in children undergoing congenital heart surgery

Manuel,

Miana,

Fonseca-Alaniz

et al. 2024

Transl Pediatr

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“…Os escores EuroSCORE II e STS têm bom poder de discriminação para prever mortalidade hospitalar de pacientes submetidos a CRM. 7 Os níveis de proteína C reativa 4 e lactato no pós-operatório 8 estão diretamente correlacionados com maiores taxas de mortalidade hospitalar e complicações. Os níveis de troponina e CK-MB são fortes preditores de mortalidade em curto e longo prazo, independentemente do uso de circulação extracorpórea.…”

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“…EuroSCORE II and STS scores have good discrimination power to predict in-hospital mortality of patients undergoing CABG. 7 Postoperative C-reactive protein 4 and lactate levels 8 are directly correlated to higher in-hospital mortality rates and complications. Troponin and CK-MB levels are stronger predictors of short and long-term mortality, regardless of the use of cardiopulmonary bypass.…”

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confidence: 99%

“…Several postoperative markers and indexes, including hemodynamic, metabolic, and biomarkers, have been identified and proposed, aiming to accurately predict poor patient outcomes. [3][4][5] Dr. Yamaguti et al 6 conducted a prospective observational study in which hemodynamic, metabolic, and tissue hypoperfusion biomarkers were analyzed in 183 patients (ages between 35 and 83 years) with left ventricular dysfunction (ejection fraction between 40% and 42,5%) who underwent coronary artery bypass surgery with cardiopulmonary bypass, according to postoperative clinical course (complicated or uncomplicated). Patients with a complicated clinical course (defined as death within 30 days after surgery or more than 4 days of ICU stay) were older (66,3 vs 59,7; p=0.002) and had a higher EuroSCORE (6 vs 3; p<0.001).…”

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confidence: 99%

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