Abstract 13094: Preoperative Low-Grade Inflammation Predicts the Development of Acute Heart Failure and the Need for Inotropic Support after Elective Coronary Artery Bypass Grafting Operation
Background: Coronary artery bypass grafting (CABG) is a major operation that frequently requires prolonged hospitalization, due to complications that include acute left ventricular failure. It is therefore important to elucidate the key mechanisms triggering left ventricular failure post-CABG in order to identify novel therapeutic targets. Monocyte chemoattractant protein-1 (MCP-1) is a chemokine with a key role in immune cell chemotaxis and may regulate the cellular infiltration of the myocardium post-CABG, while interleukin-6 (IL-6) and hsC-reactive protein (hsCRP) are key regulators of immune response. We examined the predictive role of preoperative MCP-1, IL-6 and hsCRP levels on the development of acute heart failure and the need for inotropic support after CABG.
Methods: We recruited 245 patients undergoing elective CABG. Left ventricular systolic function was evaluated preoperatively. The morning before the operation, after 8h of fasting, blood samples were obtained and the levels of MCP-1, IL-6 and hsCRP were determined by ELISA. The patients were followed up until their discharge from the hospital. The use of inotropes was recorded during their stay in the hospital.
Results: Patients that required inotropic support post-operatively had significantly higher preoperative levels of MCP-1 (A), IL-6 (B) and hsCRP (C). In multiple regression analysis, MCP-1 and IL-6 were predictors of the use of inotropes in the post-operative period (P<0.05 for both), independently of cardiovascular risk profile and preoperative left ventricular systolic function.
Conclusions: Preoperative levels of MCP-1, IL-6 and hsCRP are independent predictors of the need for post-operative inotropic support independently of pre-operative left ventricular systolic function in patients undergoing CABG. Our findings identify these biomarkers as potential therapeutic targets for the prevention of post-operative complications after cardiac surgery.
- © 2012 by American Heart Association, Inc.