Assessing the significance of some biomarkers in perioperative period after thoracic aortic reconstruction

Aim. This study aims to assess the association between levels of biomarkers and postoperative complications in patients after thoracic and thoracoabdominal aortic reconstruction.Material and methods. This study included 132 patients. The most of them underwent ascending aortic and aortic arch recons...

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Main Authors: B. A. Akselrod, O. V. Dymova, A. V. Gubko, A. P. Krasnoshchekova, D. A. Guskov, A. V. Goncharova, V. G. Gladysheva, K. V. Gubko, O. S. Kulinchenko
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Language:Russian
Published: «FIRMA «SILICEA» LLC 2023-07-01
Series:Российский кардиологический журнал
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Online Access:https://russjcardiol.elpub.ru/jour/article/view/5314
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author B. A. Akselrod
O. V. Dymova
A. V. Gubko
A. P. Krasnoshchekova
D. A. Guskov
A. V. Goncharova
V. G. Gladysheva
K. V. Gubko
O. S. Kulinchenko
author_facet B. A. Akselrod
O. V. Dymova
A. V. Gubko
A. P. Krasnoshchekova
D. A. Guskov
A. V. Goncharova
V. G. Gladysheva
K. V. Gubko
O. S. Kulinchenko
author_sort B. A. Akselrod
collection DOAJ
description Aim. This study aims to assess the association between levels of biomarkers and postoperative complications in patients after thoracic and thoracoabdominal aortic reconstruction.Material and methods. This study included 132 patients. The most of them underwent ascending aortic and aortic arch reconstruction (65 and 57, respectively).The concentrations of proadrenomedullin, presepsin, procalcitonin, troponin I and N-terminal brain natriuretic peptide were measured before induction anesthesia, at the end of the surgical operation and in 6 hours after surgery.Results. 69 patients had postoperative complications. Among them, inflammatory (27,3%) and cardiovascular complications (12,1%) prevailed. At the end of the surgical operation, the levels of the biomarkers in patients without postoperative complications and with postoperative complications were for presepsin 326 [206; 451] и 620 [332; 829] p<0,00001, tropononin I 0,77 [0,46; 1,39] and 1,49 [0,59; 3,39], p=0,01, proadrenomedullin 0,894 [0,683; 1,221] and 1,201 [0,944; 1,762], p=0,0002, procalcitonin 0,206 [0,147; 0,452] and 0,563 [0,307; 2,107], p=0,0002, respectively. According to log-linear regression model, the level of prepepsin at the end of the surgical operation >459,5 (odds ratio (OR) 6,84, 95% confidence interval (CI): 3,14-14,87) or proadrenomedullin >0,788 (OR 5,47, 95% CI: 1,52-19,68) are associated with the increased risk of postoperative complications. The level of presepsin >519,5 pg/ml at the end of the surgical operation (OR 4,55, 95% CI: 1,97-10,47) is associated with the increased risk of inflammatory complications. Regarding the prognosis of the risk of prolonged cardiotonic drug infusions, threshold values for troponin were >1,04 at the end of the surgical operation (sensitivity 75%, specificity 71,3%, AUC 0,785), >1,57 in 6 hours after surgery (sensitivity 81,3%, specificity 71,6%, AUC 0,794).Conclusion. High levels of presepsin at the end of the surgical operation may be useful to predict the postoperative complications in patients who underwent the aortic surgery however, the low levels of presepsin do not exclude the development of postoperative complications. The increased level of troponin I at the end of the surgical operation and in 6 hours after surgery can be a predictor of the need for cardiotonic support in the postoperative period.
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spelling doaj-art-eae9fd05600a48eea0c43c82b1f2d5282025-08-20T03:21:31Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202023-07-01282S10.15829/1560-4071-2023-53143833Assessing the significance of some biomarkers in perioperative period after thoracic aortic reconstructionB. A. Akselrod0O. V. Dymova1A. V. Gubko2A. P. Krasnoshchekova3D. A. Guskov4A. V. Goncharova5V. G. Gladysheva6K. V. Gubko7O. S. Kulinchenko8B.V. Petrovsky Russian Scientific Center of SurgeryB.V. Petrovsky Russian Scientific Center of SurgeryB.V. Petrovsky Russian Scientific Center of SurgeryB.V. Petrovsky Russian Scientific Center of SurgeryB.V. Petrovsky Russian Scientific Center of SurgeryB.V. Petrovsky Russian Scientific Center of SurgeryB.V. Petrovsky Russian Scientific Center of SurgeryB.V. Petrovsky Russian Scientific Center of SurgeryB.V. Petrovsky Russian Scientific Center of SurgeryAim. This study aims to assess the association between levels of biomarkers and postoperative complications in patients after thoracic and thoracoabdominal aortic reconstruction.Material and methods. This study included 132 patients. The most of them underwent ascending aortic and aortic arch reconstruction (65 and 57, respectively).The concentrations of proadrenomedullin, presepsin, procalcitonin, troponin I and N-terminal brain natriuretic peptide were measured before induction anesthesia, at the end of the surgical operation and in 6 hours after surgery.Results. 69 patients had postoperative complications. Among them, inflammatory (27,3%) and cardiovascular complications (12,1%) prevailed. At the end of the surgical operation, the levels of the biomarkers in patients without postoperative complications and with postoperative complications were for presepsin 326 [206; 451] и 620 [332; 829] p<0,00001, tropononin I 0,77 [0,46; 1,39] and 1,49 [0,59; 3,39], p=0,01, proadrenomedullin 0,894 [0,683; 1,221] and 1,201 [0,944; 1,762], p=0,0002, procalcitonin 0,206 [0,147; 0,452] and 0,563 [0,307; 2,107], p=0,0002, respectively. According to log-linear regression model, the level of prepepsin at the end of the surgical operation >459,5 (odds ratio (OR) 6,84, 95% confidence interval (CI): 3,14-14,87) or proadrenomedullin >0,788 (OR 5,47, 95% CI: 1,52-19,68) are associated with the increased risk of postoperative complications. The level of presepsin >519,5 pg/ml at the end of the surgical operation (OR 4,55, 95% CI: 1,97-10,47) is associated with the increased risk of inflammatory complications. Regarding the prognosis of the risk of prolonged cardiotonic drug infusions, threshold values for troponin were >1,04 at the end of the surgical operation (sensitivity 75%, specificity 71,3%, AUC 0,785), >1,57 in 6 hours after surgery (sensitivity 81,3%, specificity 71,6%, AUC 0,794).Conclusion. High levels of presepsin at the end of the surgical operation may be useful to predict the postoperative complications in patients who underwent the aortic surgery however, the low levels of presepsin do not exclude the development of postoperative complications. The increased level of troponin I at the end of the surgical operation and in 6 hours after surgery can be a predictor of the need for cardiotonic support in the postoperative period.https://russjcardiol.elpub.ru/jour/article/view/5314biomarkerspresepsinproadrenomedullinprocalcitonintroponin in-terminal brain natriuretic peptidecardiosurgeryaortic archascending aorta
spellingShingle B. A. Akselrod
O. V. Dymova
A. V. Gubko
A. P. Krasnoshchekova
D. A. Guskov
A. V. Goncharova
V. G. Gladysheva
K. V. Gubko
O. S. Kulinchenko
Assessing the significance of some biomarkers in perioperative period after thoracic aortic reconstruction
Российский кардиологический журнал
biomarkers
presepsin
proadrenomedullin
procalcitonin
troponin i
n-terminal brain natriuretic peptide
cardiosurgery
aortic arch
ascending aorta
title Assessing the significance of some biomarkers in perioperative period after thoracic aortic reconstruction
title_full Assessing the significance of some biomarkers in perioperative period after thoracic aortic reconstruction
title_fullStr Assessing the significance of some biomarkers in perioperative period after thoracic aortic reconstruction
title_full_unstemmed Assessing the significance of some biomarkers in perioperative period after thoracic aortic reconstruction
title_short Assessing the significance of some biomarkers in perioperative period after thoracic aortic reconstruction
title_sort assessing the significance of some biomarkers in perioperative period after thoracic aortic reconstruction
topic biomarkers
presepsin
proadrenomedullin
procalcitonin
troponin i
n-terminal brain natriuretic peptide
cardiosurgery
aortic arch
ascending aorta
url https://russjcardiol.elpub.ru/jour/article/view/5314
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