Aprotinin reduces the procalcitonin rise associated with complex cardiac surgery and cardiopulmonary bypass
Aprotinin, a nonspecific serine protease inhibitor, has been primarily used as a haemostatic drug in cardiac surgery with cardio-pulmonary bypass (CPB). This study investigated the effect of aprotinin on the post-operative levels of procalcitonin (PCT) and a set of cytokines in patients undergoing p...
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| Veröffentlicht in: | Physiological research 2013-01, Vol.62 (1), p.27-33 |
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| creator | Maruna, P Klein, A A Kunstýř, J Plocová, K M Mlejnský, F Lindner, J |
| description | Aprotinin, a nonspecific serine protease inhibitor, has been primarily used as a haemostatic drug in cardiac surgery with cardio-pulmonary bypass (CPB). This study investigated the effect of aprotinin on the post-operative levels of procalcitonin (PCT) and a set of cytokines in patients undergoing pulmonary artery endarterectomy (PEA). We analyzed 60 patients with chronic thromboembolic pulmonary hypertension undergoing PEA. 30 patients (Group A) were treated with aprotinin (2,00,00 IU prior anesthesia, then 2,00,00 IU in CPB prime and 50,00 IU per hour continuously); a further 30 patients (Group B) received tranexamic Acid (1 g before anesthesia, 1 g after full heparin dose and 2 g in CPB prime). PCT, TNFalpha, IL-1beta, IL-6, and IL-8 arterial concentrations were measured from before until 72 hours after surgery. Aprotinin significantly affected early post-PEA plasma PCT. Patients treated with aprotinin (Group A) had lower peak PCT levels compared to patients in Group B (1.52 ng/ml versus 2.18, p=0.024). Postoperative peak values of PCT and IL-6 correlated closely in both groups (r=0.78, r=0.83 respectively). Aprotinin attenuates the post-PEA increase of PCT in the same manner as other pro-inflammatory cytokines. Significant correlation between PCT and IL-6 post-surgery may be indicative of an indirect IL-6-mediated pathway of PCT alteration. |
| doi_str_mv | 10.33549/physiolres.932375 |
| format | Article |
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This study investigated the effect of aprotinin on the post-operative levels of procalcitonin (PCT) and a set of cytokines in patients undergoing pulmonary artery endarterectomy (PEA). We analyzed 60 patients with chronic thromboembolic pulmonary hypertension undergoing PEA. 30 patients (Group A) were treated with aprotinin (2,00,00 IU prior anesthesia, then 2,00,00 IU in CPB prime and 50,00 IU per hour continuously); a further 30 patients (Group B) received tranexamic Acid (1 g before anesthesia, 1 g after full heparin dose and 2 g in CPB prime). PCT, TNFalpha, IL-1beta, IL-6, and IL-8 arterial concentrations were measured from before until 72 hours after surgery. Aprotinin significantly affected early post-PEA plasma PCT. Patients treated with aprotinin (Group A) had lower peak PCT levels compared to patients in Group B (1.52 ng/ml versus 2.18, p=0.024). Postoperative peak values of PCT and IL-6 correlated closely in both groups (r=0.78, r=0.83 respectively). Aprotinin attenuates the post-PEA increase of PCT in the same manner as other pro-inflammatory cytokines. Significant correlation between PCT and IL-6 post-surgery may be indicative of an indirect IL-6-mediated pathway of PCT alteration.</description><identifier>ISSN: 0862-8408</identifier><identifier>EISSN: 1802-9973</identifier><identifier>DOI: 10.33549/physiolres.932375</identifier><identifier>PMID: 23173677</identifier><language>eng</language><publisher>Czech Republic: Institute of Physiology</publisher><subject>Aged ; Aprotinin - therapeutic use ; Biomarkers - blood ; Calcitonin - blood ; Calcitonin Gene-Related Peptide ; Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Cytokines ; Drug dosages ; Endarterectomy ; Female ; Heart surgery ; Hemostatics - therapeutic use ; Humans ; Hypertension ; Hypertension, Pulmonary - blood ; Hypertension, Pulmonary - etiology ; Hypertension, Pulmonary - surgery ; Inflammation Mediators - blood ; Interleukin-1beta - blood ; Interleukin-6 - blood ; Interleukin-8 - blood ; Ischemia ; Male ; Middle Aged ; Plasma ; Protein Precursors - blood ; Pulmonary arteries ; Pulmonary Embolism - blood ; Pulmonary Embolism - complications ; Pulmonary Embolism - surgery ; Rodents ; Sample size ; Statistical analysis ; Teaching hospitals ; Time Factors ; Tranexamic Acid - therapeutic use ; Treatment Outcome ; Tumor Necrosis Factor-alpha - blood ; Up-Regulation ; Veins & arteries</subject><ispartof>Physiological research, 2013-01, Vol.62 (1), p.27-33</ispartof><rights>Copyright Institute of Physiology 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c342t-89e2ab0960b64b79436d95bde31448c231b54690ee5388590dbdaae2f40fbb973</citedby><cites>FETCH-LOGICAL-c342t-89e2ab0960b64b79436d95bde31448c231b54690ee5388590dbdaae2f40fbb973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,860,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23173677$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maruna, P</creatorcontrib><creatorcontrib>Klein, A A</creatorcontrib><creatorcontrib>Kunstýř, J</creatorcontrib><creatorcontrib>Plocová, K M</creatorcontrib><creatorcontrib>Mlejnský, F</creatorcontrib><creatorcontrib>Lindner, J</creatorcontrib><title>Aprotinin reduces the procalcitonin rise associated with complex cardiac surgery and cardiopulmonary bypass</title><title>Physiological research</title><addtitle>Physiol Res</addtitle><description>Aprotinin, a nonspecific serine protease inhibitor, has been primarily used as a haemostatic drug in cardiac surgery with cardio-pulmonary bypass (CPB). This study investigated the effect of aprotinin on the post-operative levels of procalcitonin (PCT) and a set of cytokines in patients undergoing pulmonary artery endarterectomy (PEA). We analyzed 60 patients with chronic thromboembolic pulmonary hypertension undergoing PEA. 30 patients (Group A) were treated with aprotinin (2,00,00 IU prior anesthesia, then 2,00,00 IU in CPB prime and 50,00 IU per hour continuously); a further 30 patients (Group B) received tranexamic Acid (1 g before anesthesia, 1 g after full heparin dose and 2 g in CPB prime). PCT, TNFalpha, IL-1beta, IL-6, and IL-8 arterial concentrations were measured from before until 72 hours after surgery. Aprotinin significantly affected early post-PEA plasma PCT. Patients treated with aprotinin (Group A) had lower peak PCT levels compared to patients in Group B (1.52 ng/ml versus 2.18, p=0.024). Postoperative peak values of PCT and IL-6 correlated closely in both groups (r=0.78, r=0.83 respectively). Aprotinin attenuates the post-PEA increase of PCT in the same manner as other pro-inflammatory cytokines. Significant correlation between PCT and IL-6 post-surgery may be indicative of an indirect IL-6-mediated pathway of PCT alteration.</description><subject>Aged</subject><subject>Aprotinin - therapeutic use</subject><subject>Biomarkers - blood</subject><subject>Calcitonin - blood</subject><subject>Calcitonin Gene-Related Peptide</subject><subject>Cardiac Surgical Procedures</subject><subject>Cardiopulmonary Bypass</subject><subject>Cytokines</subject><subject>Drug dosages</subject><subject>Endarterectomy</subject><subject>Female</subject><subject>Heart surgery</subject><subject>Hemostatics - therapeutic use</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension, Pulmonary - blood</subject><subject>Hypertension, Pulmonary - etiology</subject><subject>Hypertension, Pulmonary - surgery</subject><subject>Inflammation Mediators - blood</subject><subject>Interleukin-1beta - blood</subject><subject>Interleukin-6 - blood</subject><subject>Interleukin-8 - blood</subject><subject>Ischemia</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Plasma</subject><subject>Protein Precursors - blood</subject><subject>Pulmonary arteries</subject><subject>Pulmonary Embolism - blood</subject><subject>Pulmonary Embolism - complications</subject><subject>Pulmonary Embolism - surgery</subject><subject>Rodents</subject><subject>Sample size</subject><subject>Statistical analysis</subject><subject>Teaching hospitals</subject><subject>Time Factors</subject><subject>Tranexamic Acid - therapeutic use</subject><subject>Treatment Outcome</subject><subject>Tumor Necrosis Factor-alpha - blood</subject><subject>Up-Regulation</subject><subject>Veins & arteries</subject><issn>0862-8408</issn><issn>1802-9973</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpFUMtOwzAQtBCIlsIPcECWOAcc20nsY1XxkipxgXPkx4a6pHGwE0H_HtMWOK00O7M7Mwhd5uSGsYLL2361jc63AeKNZJRVxRGa5oLQTMqKHaMpESXNBCdigs5iXBNCK1KxUzShLK9YWVVT9D7vgx9c5zocwI4GIh5WgBNoVGvc4HcbFwGrGL1xagCLP92wwsZv-ha-sFHBOmVwHMMbhC1Wnd1jvh_bje9UwvS2T_JzdNKoNsLFYc7Q6_3dy-IxWz4_PC3my8wwTodMSKBKE1kSXXJdSc5KKwttgeWcC5O864KXkgAUTIhCEqutUkAbThqtU_IZut7fTSk-RohDvfZj6NLLOmf8RyG4TCy6Z5ngYwzQ1H1wm-S2zkm967f-77fe95tEV4fTo96A_ZP8Fsq-AeC7e_Y</recordid><startdate>20130101</startdate><enddate>20130101</enddate><creator>Maruna, P</creator><creator>Klein, A A</creator><creator>Kunstýř, J</creator><creator>Plocová, K M</creator><creator>Mlejnský, F</creator><creator>Lindner, J</creator><general>Institute of Physiology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BYOGL</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope></search><sort><creationdate>20130101</creationdate><title>Aprotinin reduces the procalcitonin rise associated with complex cardiac surgery and cardiopulmonary bypass</title><author>Maruna, P ; Klein, A A ; Kunstýř, J ; Plocová, K M ; Mlejnský, F ; Lindner, J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c342t-89e2ab0960b64b79436d95bde31448c231b54690ee5388590dbdaae2f40fbb973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aprotinin - therapeutic use</topic><topic>Biomarkers - blood</topic><topic>Calcitonin - blood</topic><topic>Calcitonin Gene-Related Peptide</topic><topic>Cardiac Surgical Procedures</topic><topic>Cardiopulmonary Bypass</topic><topic>Cytokines</topic><topic>Drug dosages</topic><topic>Endarterectomy</topic><topic>Female</topic><topic>Heart surgery</topic><topic>Hemostatics - therapeutic use</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension, Pulmonary - blood</topic><topic>Hypertension, Pulmonary - etiology</topic><topic>Hypertension, Pulmonary - surgery</topic><topic>Inflammation Mediators - blood</topic><topic>Interleukin-1beta - blood</topic><topic>Interleukin-6 - blood</topic><topic>Interleukin-8 - blood</topic><topic>Ischemia</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Plasma</topic><topic>Protein Precursors - blood</topic><topic>Pulmonary arteries</topic><topic>Pulmonary Embolism - blood</topic><topic>Pulmonary Embolism - complications</topic><topic>Pulmonary Embolism - surgery</topic><topic>Rodents</topic><topic>Sample size</topic><topic>Statistical analysis</topic><topic>Teaching hospitals</topic><topic>Time Factors</topic><topic>Tranexamic Acid - therapeutic use</topic><topic>Treatment Outcome</topic><topic>Tumor Necrosis Factor-alpha - blood</topic><topic>Up-Regulation</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maruna, P</creatorcontrib><creatorcontrib>Klein, A A</creatorcontrib><creatorcontrib>Kunstýř, J</creatorcontrib><creatorcontrib>Plocová, K M</creatorcontrib><creatorcontrib>Mlejnský, F</creatorcontrib><creatorcontrib>Lindner, J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>East Europe, Central Europe Database</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><jtitle>Physiological research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maruna, P</au><au>Klein, A A</au><au>Kunstýř, J</au><au>Plocová, K M</au><au>Mlejnský, F</au><au>Lindner, J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Aprotinin reduces the procalcitonin rise associated with complex cardiac surgery and cardiopulmonary bypass</atitle><jtitle>Physiological research</jtitle><addtitle>Physiol Res</addtitle><date>2013-01-01</date><risdate>2013</risdate><volume>62</volume><issue>1</issue><spage>27</spage><epage>33</epage><pages>27-33</pages><issn>0862-8408</issn><eissn>1802-9973</eissn><abstract>Aprotinin, a nonspecific serine protease inhibitor, has been primarily used as a haemostatic drug in cardiac surgery with cardio-pulmonary bypass (CPB). This study investigated the effect of aprotinin on the post-operative levels of procalcitonin (PCT) and a set of cytokines in patients undergoing pulmonary artery endarterectomy (PEA). We analyzed 60 patients with chronic thromboembolic pulmonary hypertension undergoing PEA. 30 patients (Group A) were treated with aprotinin (2,00,00 IU prior anesthesia, then 2,00,00 IU in CPB prime and 50,00 IU per hour continuously); a further 30 patients (Group B) received tranexamic Acid (1 g before anesthesia, 1 g after full heparin dose and 2 g in CPB prime). PCT, TNFalpha, IL-1beta, IL-6, and IL-8 arterial concentrations were measured from before until 72 hours after surgery. Aprotinin significantly affected early post-PEA plasma PCT. Patients treated with aprotinin (Group A) had lower peak PCT levels compared to patients in Group B (1.52 ng/ml versus 2.18, p=0.024). Postoperative peak values of PCT and IL-6 correlated closely in both groups (r=0.78, r=0.83 respectively). Aprotinin attenuates the post-PEA increase of PCT in the same manner as other pro-inflammatory cytokines. Significant correlation between PCT and IL-6 post-surgery may be indicative of an indirect IL-6-mediated pathway of PCT alteration.</abstract><cop>Czech Republic</cop><pub>Institute of Physiology</pub><pmid>23173677</pmid><doi>10.33549/physiolres.932375</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aprotinin - therapeutic use Biomarkers - blood Calcitonin - blood Calcitonin Gene-Related Peptide Cardiac Surgical Procedures Cardiopulmonary Bypass Cytokines Drug dosages Endarterectomy Female Heart surgery Hemostatics - therapeutic use Humans Hypertension Hypertension, Pulmonary - blood Hypertension, Pulmonary - etiology Hypertension, Pulmonary - surgery Inflammation Mediators - blood Interleukin-1beta - blood Interleukin-6 - blood Interleukin-8 - blood Ischemia Male Middle Aged Plasma Protein Precursors - blood Pulmonary arteries Pulmonary Embolism - blood Pulmonary Embolism - complications Pulmonary Embolism - surgery Rodents Sample size Statistical analysis Teaching hospitals Time Factors Tranexamic Acid - therapeutic use Treatment Outcome Tumor Necrosis Factor-alpha - blood Up-Regulation Veins & arteries |
| title | Aprotinin reduces the procalcitonin rise associated with complex cardiac surgery and cardiopulmonary bypass |
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