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Inflammation and Perioperative Cardiovascular Events.

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Surgery triggers a stress response, increasing inflammation and cardiac risks. Monitoring inflammatory biomarkers and managing inflammation can improve patient outcomes and reduce perioperative cardiac events.

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Area of Science:

  • Cardiovascular Surgery
  • Anesthesiology
  • Immunology

Background:

  • Surgery and anesthesia induce a stress response, leading to sympathetic stimulation, cortisol secretion, hypercoagulability, and systemic inflammation.
  • These homeostatic changes, particularly systemic inflammation, elevate the risk of organ damage and perioperative cardiac complications, impacting both cardiovascular and non-cardiac surgeries.
  • Preoperative inflammatory markers are linked to perioperative cardiovascular events, highlighting the role of inflammation in surgical risk.

Purpose of the Study:

  • To explore the role of systemic inflammation in perioperative cardiac complications.
  • To identify the utility of inflammatory biomarkers in predicting cardiovascular events.
  • To discuss strategies for reducing perioperative inflammatory response and improving surgical outcomes.

Main Methods:

  • Review of contemporary literature on surgical stress response and inflammation.
  • Analysis of traditional (CRP, BNP) and novel biomarkers (galectin-3, TNF-α, MiRNAs) for predicting inflammatory response and cardiac injury.
  • Discussion of methods to prevent and treat systemic inflammation perioperatively.

Main Results:

  • Surgical procedures can trigger systemic inflammation, characterized by proinflammatory cytokine secretion, neutrophil activation, and tissue damage.
  • Inflammatory biomarkers, including novel ones like galectin-3 and MiRNAs, can predict perioperative cardiac injury and cardiovascular events.
  • Inflammatory markers increase post-surgery and typically decline within weeks, but elevated preoperative levels are significant predictors.

Conclusions:

  • Determining inflammatory markers perioperatively can identify high-risk patients for cardiovascular events.
  • Reducing perioperative inflammatory response is crucial for improving surgical outcomes.
  • Optimizing surgical and anesthetic management, alongside pharmacological interventions like interleukin inhibitors, can mitigate systemic inflammation and enhance perioperative cardiac risk reduction strategies.