1. bookVolume 26 (2018): Issue 3 (July 2018)
Journal Details
License
Format
Journal
eISSN
2284-5623
First Published
08 Aug 2013
Publication timeframe
4 times per year
Languages
English
access type Open Access

Postoperative interleukin-8 levels are related to the duration of coronary artery bypass grafting surgery and predict in-hospital postsurgical complications

Published Online: 31 Jul 2018
Page range: 293 - 303
Received: 22 Feb 2018
Accepted: 20 May 2018
Journal Details
License
Format
Journal
eISSN
2284-5623
First Published
08 Aug 2013
Publication timeframe
4 times per year
Languages
English
Abstract

Introduction: The magnitude of the very early coronary artery bypass grafting (CABG)-related inflammatory response has been shown to influence post-CABG outcomes. However, the dynamics of the systemic inflammatory response to CABG beyond the very early postoperative phase and its relevance to clinical outcomes are not fully understood.

Methods: Circulating levels of several inflammatory markers were determined in 30 consecutive patients undergoing elective isolated on-pump CABG one day prior (D0-1), and 2 (D2) and 5 days post-CABG.

Results: CABG was associated with a significant increase in all studied inflammatory marker levels (all p<0.05 for D2 versus D0-1). D2 post-CABG IL-6 and IL-8 levels were both significantly positively correlated with extracorporeal circulation (ECC) and aortic clamping (AC) times (all p<0.05), whereas a weaker correlation was observed between D2 post-CABG IL-8 levels and total surgery time (r=0.42, p=0.02). In multiple regression analysis, D2 IL-8 levels independently predicted post-CABG kidney (p= 0.02) and liver (p = 0.04) dysfunction, as well as a sum of post-CABG major complications ≥2 (p = 0.04).

Conclusions: In this prospective study, longer duration of cardiopulmonary bypass caused a larger post-CABG inflammatory surge, whereas the duration of total CABG surgery had a less significant effect. IL-8 hyperresponders had greater risk of developing kidney and liver dysfunction and presented more major post-CABG complications. These data suggest that targeting the IL-8 pathway using antiinflammatory agents, or simply by shortening the duration of cardiopulmonary bypass could improve the in-hospital post-CABG outcomes in this population.

Keywords

1. Moazzami K, Dolmatova E, Maher J, Gerula C, Sambol J, Klapholz M, et al. In-hospital outcomes and complications of coronary artery bypass grafting in the United States between 2008 and 2012. J Cardiothorac Vasc Anesth. 2017;31(1):19-25. DOI: 10.1053/j.jvca.2016.08.00810.1053/j.jvca.2016.08.008Open DOISearch in Google Scholar

2. Yamaji K, Ueki Y, Souteyrand G, Daemen J, Wiebe J, Nef H, et al. Mechanisms of very late bioresorbable scaffold thrombosis: The INVEST registry. J Am Coll Cardiol. 2017;70(19):2330-44. DOI: 10.1016/j.jacc.2017.09.01410.1016/j.jacc.2017.09.014Open DOISearch in Google Scholar

3. Șerban R, Scridon A, Dobreanu D, Elkaholut A. Coronary artery aneurysm formation within everolimus-eluting bioresorbable stent. Int J Cardiol. 2014;177:e4-5. DOI: 10.1016/j.ijcard.2014.07.19710.1016/j.ijcard.2014.07.197Open DOISearch in Google Scholar

4. DiNicolantonio JJ, D’Ascenzo F, Tomek A, Chatterjee S, Niazi AK, Biondi-Zoccai G. Clopidogrel is safer than ticagrelor in regard to bleeds: a closer look at the PLATO trial. Int J Cardiol. 2013;168(3):1739-44. DOI: 10.1016/j.ijcard.2013.06.13510.1016/j.ijcard.2013.06.135Open DOISearch in Google Scholar

5. Mohr FW, Morice MC, Kappetein AP, Feldman TE, Ståhle E, Colombo A, et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. Lancet. 2013;381:629-38. DOI: 10.1016/S0140-6736(13)60141-510.1016/S0140-6736(13)60141-5Open DOISearch in Google Scholar

6. Piątek J, Kędziora A, Konstanty-Kalandyk J, Kiełbasa G, Olszewska M, Song BH, et al. Risk factors for in-hospital mortality after coronary artery bypass grafting in patients 80 years old or older: a retrospective case-series study. PeerJ. 2016;4:e2667. DOI: 10.7717/peerj.266710.7717/peerj.2667Open DOISearch in Google Scholar

7. Turrentine FE, Wang H, Simpson VB, Jones RS. Surgical risk factors, morbidity, and mortality in elderly patients. J Am Coll Surg. 2006;203(6):865-77. DOI: 10.1016/j.jamcollsurg.2006.08.02610.1016/j.jamcollsurg.2006.08.026Open DOISearch in Google Scholar

8. Poole L, Kidd T, Leigh E, Ronaldson A, Jahangiri M, Steptoea A. Depression, C-reactive protein and length of post-operative hospital stay in coronary artery bypass graft surgery patients. Brain Behav Immun. 2014;37(100):115-21. DOI: 10.1016/j.bbi.2013.11.00810.1016/j.bbi.2013.11.008Search in Google Scholar

9. Holmes JH 4th, Connolly NC, Paull DL, Hill ME, Guyton SW, Ziegler SF, et al. Magnitude of the inflammatory response to cardiopulmonary bypass and its relation to adverse clinical outcomes. Inflamm Res. 2002;51(12):579-86. DOI: 10.1007/PL0001243210.1007/PL00012432Open DOISearch in Google Scholar

10. Royston D. Serine protease inhibition prevents both cellular and humoral responses to cardiopulmonary bypass. J Cardiovasc Pharmacol. 1996;27(Suppl. 1):S42-9. DOI: 10.1097/00005344-199600001-0001010.1097/00005344-199600001-00010Search in Google Scholar

11. Cernea S, Şular FL, Huţanu A, Voidăzan S. Markers of cognitive impairment in patients with type 2 diabetes. Rev Rom Med Lab. 2016;24(2):161-76. DOI: 10.1515/rrlm-2016-002310.1515/rrlm-2016-0023Open DOISearch in Google Scholar

12. Hennein HA, Ebba H, Rodriguez JL, Merrick SH, Keith FM, Bronstein MH, et al. Relationship of the proinflammatory cytokines to myocardial ischemia and dysfunction after uncomplicated coronary revascularization. J Thorac Cardiovasc Surg. 1994;108(4):626-35.10.1016/S0022-5223(94)70286-1Search in Google Scholar

13. Bruins P, te Velthuis H, Yazdanbakhsh AP, Jansen PG, van Hardevelt FW, de Beaumont EM, et al. Activation of the complement system during and after cardiopulmonary bypass surgery: postsurgery activation involves C-reactive protein and is associated with postoperative arrhythmia. Circulation. 1997;96(10):3542-8. DOI: 10.1161/01.CIR.96.10.354210.1161/01.CIR.96.10.3542Search in Google Scholar

14. Finkel MS, Oddis CV, Jacob TD, Watkins SC, Hattier BG, Simmons RL. Negative inotropic effects of cytokines on the heart mediated by nitric oxide. Science. 1992;257:387-9. DOI: 10.1126/science.163156010.1126/.1631560Open DOISearch in Google Scholar

15. Van Zee KJ, Fischer E, Hawes AS, Hébert CA, Terrell TG, Baker JB, et al. Effects of intravenous IL-8 administration in nonhuman primates. J Immunol. 1992;148(6):1746-52.Search in Google Scholar

16. Mitchell JD, Grocott HP, Phillips-Bute B, Mathew JP, Newman MF, Bar-Yosef S. Cytokine secretion after cardiac surgery and its relationship to postoperative fever. Cytokine. 2007;38(1):37-42. DOI: 10.1016/j.cyto.2007.04.00910.1016/j.cyto.2007.04.009Open DOISearch in Google Scholar

17. Metinko A, Kunkel S, Standiford T, Streter R. Monocyte expression of interleukin-8 in response to oxidant stress. FASEB J Abstracts Part 1. 1991:1941;A704 (Abstract).Search in Google Scholar

18. Søraas CL, Friis C, Engebretsen KV, Sandvik L, Kjeldsen SE, Tønnessen T. Troponin T is a better predictor than creatine kinase-MB of long-term mortality after coronary artery bypass graft surgery. Am Heart J. 2012;164(5):779-85. DOI: 10.1016/j.ahj.2012.05.02710.1016/j.ahj.2012.05.027Open DOISearch in Google Scholar

19. Kawamura T, Wakusawa R, Okada K, Inada S. Elevation of cytokines during open heart surgery with cardio-pulmonary bypass: participation of interleukin 8 and 6 in reperfusion injury. Can J Anaesth. 1993;40(11):1016-21. DOI: 10.1007/BF0300947010.1007/BF03009470Search in Google Scholar

20. Wu ZK, Laurikka J, Vikman S, Nieminen R, Moilanen E, Tarkka MR. High postoperative interleukin-8 levels related to atrial fibrillation in patients undergoing coronary artery bypass surgery. World J Surg. 2008;32(12):2643-9. DOI: 10.1007/s00268-008-9758-710.1007/s00268-008-9758-7Open DOISearch in Google Scholar

21. Kirklin, JW, Barratt-Boyes, BG. Hypothermia, circulatory arrest, and cardiopulmonary bypass. In: Cardiac surgery. 2nd ed. Churchill Livingstone, New York; 1993: 61-128.Search in Google Scholar

22. Gurbuz O, Kumtepe G, Ercan A, Yolgosteren A, Ozkan H, Karal IH, et al. A comparison of off- and on-pump beating-heart coronary artery bypass surgery on long-term cardiovascular events. Cardiovasc J Afr. 2017;28(1):30-5. DOI: 10.5830/CVJA-2016-04910.5830/CVJA-2016-049Open DOISearch in Google Scholar

23. Wang J, Yu W, Zhao D, Liu N, Yu Y. In-hospital and long-term mortality in 35,173 Chinese patients undergoing coronary artery bypass grafting in Beijing: impact of sex, age, myocardial infarction, and cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2017;31(1):26-31. DOI: 10.1053/j.jvca.2016.08.00410.1053/j.jvca.2016.08.004Open DOISearch in Google Scholar

24. Takagi H, Umemoto T. All-Literature Investigation of Cardiovascular Evidence (ALICE) Group: Worse long-term survival after off-pump than on-pump coronary artery bypass grafting. J Thorac Cardiovasc Surg. 2014;148:1820-9. DOI: 10.1016/j.jtcvs.2014.05.03410.1016/j.jtcvs.2014.05.034Open DOISearch in Google Scholar

25. Mathison M, Edgerton JR, Horswell JL, Akin JJ, Mack MJ. Analysis of hemodynamic changes during beating heart surgical procedures. Ann Thorac Surg. 2000;70:1355-60. DOI: 10.1016/S0003-4975(00)01590-310.1016/S0003-4975(00)01590-3Open DOISearch in Google Scholar

26. Göber V, Hohl A, Gahl B, Dick F, Eigenmann V, Carrel TP, et al. Early troponin T and prediction of potentially correctable in-hospital complications after coronary artery bypass grafting surgery. PLoS One. 2013;8(9):e74241. DOI: 10.1371/journal.pone.007424110.1371/journal.pone.0074241Search in Google Scholar

27. Lehrke S, Steen H, Sievers HH, Peters H, Opitz A, Müller-Bardorff M, et al. Cardiac troponin T for prediction of short- and long-term morbidity and mortality after elective open heart surgery. Clin Chem. 2004;50(9):1560-7. DOI: 10.1373/clinchem.2004.03146810.1373/clinchem.2004.031468Open DOISearch in Google Scholar

28. Kathiresan S, Servoss SJ, Newell JB, Trani D, Mac-Gillivray TE, Lewandrowski K, et al. Cardiac troponin T elevation after coronary artery bypass grafting is associated with increased one-year mortality. Am J Cardiol. 2004;94(7):879-81. DOI: 10.1016/j.amj-card.2004.06.02210.1016/j.amj-card.2004.06.022Open DOISearch in Google Scholar

29. Carrier M, Pellerin M, Perrault LP, Solymoss BC, Pelletier LC. Troponin levels in patients with myocardial infarction after coronary artery bypass grafting. Ann Thorac Surg. 2000;69(2):435-40. DOI: 10.1016/S0003-4975(99)01294-110.1016/S0003-4975(99)01294-1Open DOISearch in Google Scholar

30. Mukaida N, Shiroo M, Matsusima K. Genomic structure of the human monocyte-derived neutrophil chemo-tactic factor IL-8. J Immunol. 1989;143:1366-71.Search in Google Scholar

31. Standiford TJ, Strieter RM, Chensue SI, Westwick J, Kasahara K, Kunkel SL. IL-4 inhibits the expression of IL-8 from stimulated monocytes. J Immunol. 1990;145:1435-9.Search in Google Scholar

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