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Soluble adhesion molecules in coronary artery bypass surgery
Minxin Wei1, Jari Laurikka, Pekka Kuukasjärvi
1Division of Cardiovascular Surgery, Tampere University Hospital, Tampere, Finland.
Asian Cardiovascular & Thoracic Annals
|September 30, 2003
Summary
Soluble adhesion molecules sP-selectin and sICAM-1 increased after heart surgery, but did not correlate with myocardial injury. However, elevated sE-selectin and sICAM-1 levels were linked to the need for vasopressors.
Area of Science:
- Cardiovascular Surgery
- Immunology
- Biomarkers
Background:
- Cardiopulmonary bypass (CPB) can trigger inflammatory responses.
- Soluble adhesion molecules (sAMs) like sE-selectin, sP-selectin, and sICAM-1 are markers of endothelial activation and inflammation.
Purpose of the Study:
- To investigate the dynamic changes in plasma levels of sE-selectin, sP-selectin, and sICAM-1 following coronary artery bypass grafting (CABG) surgery.
- To determine the correlation between these sAM levels and postoperative myocardial injury, bypass duration, and hemodynamic parameters.
- To assess the relationship between sAM levels and the requirement for vasopressor support.
Main Methods:
- Plasma levels of sE-selectin, sP-selectin, and sICAM-1 were measured in 37 male patients before and at several time points after CPB during CABG surgery.
- Hemodynamic data and creatine kinase-MB levels were monitored.
- Correlation analyses were performed to assess relationships between sAM levels and clinical parameters.
Main Results:
- Plasma sP-selectin levels significantly increased post-CPB, peaking at 4 hours.
- Plasma sICAM-1 levels initially decreased, then recovered and significantly increased at 20 hours post-CPB.
- Elevated sE-selectin and sICAM-1 levels were observed in patients requiring norepinephrine, indicating a correlation with vasopressor use, but not with myocardial injury or bypass duration.
Conclusions:
- Transient changes in plasma sAMs after CABG are not associated with postoperative myocardial injury in low-risk patients.
- The increase in sE-selectin and sICAM-1 correlates with the need for vasopressor support, suggesting their potential role as indicators of hemodynamic instability or inflammatory response severity.