Use of humoral biomarkers of inflammation in predicting coronary bypass grafts dysfunction

Authors: Buziashvili Yu.I., Koksheneva I.V., Golubev E.P., Tugeeva E.F., Iraskhanov A.Sh., Avkhadov U.S.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2024-18-3-350-361

For citation: Buziashvili Yu.I., Koksheneva I.V., Golubev E.P., Tugeeva E.F., Iraskhanov A.Sh., Avkhadov U.S. Use of humoral biomarkers of inflammation in predicting coronary bypass grafts dysfunction. Creative Cardiology. 2024; 18 (3): 350–361 (in Russ.). DOI: 10.24022/1997-3187-2024-18-3-350-361

Received / Accepted:  01.07.2024 / 15.08.2024

Keywords: coronary artery bypass grafting coronary artery bypass graft dysfunction activation of the inflammatory response adverse cardiovascular events high-sensitivity C-reactive protein fractalkine neopterin interleukin-1beta



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Abstract

Objective. To determine the role of activation of the systemic inflammatory response in the development of shunt dysfunction and adverse cardiovascular events in the mid-term after coronary artery bypass grafting (CABG), to develop an optimal risk stratification algorithm and principles for the management of high-risk patients after CABG.Material and methods. The study included 84 patients with stable coronary artery disease who underwent examination and surgical treatment – isolated CABG. Assessment of humoral markers of inflammation (highly sensitive C-reactive protein (hs-CRP), interleukin (IL) 1β, IL-6, IL-18, tumor necrosis factor-α (TNF-α), placental growth factor (PlGF), fractalkine, neopterin) was carried out before surgery, 24 hours after CABG and 7 days after surgery. Control coronary bypass grafting was performed intraoperatively and 1 year after CABG.

Results. 1 year after CABG, dysfunction of the coronary conduits was determined in 12% of patients, which was caused: in 70% of cases by thrombotic occlusion of the venous graft, in 30% by hemodynamically significant stenosis of the graft. Logistic models were built to predict the risk of adverse outcomes in the mid-term period after CABG depending on the values of fractalkine level before surgery and on the 1st day after surgery, the Duke Index, which showed high values of sensitivity and specificity. The diagnostic significance of the following biomarkers of inflammation was determined using the ROC curve method: fractalkine levels before surgery (p = 0.008); hs-CRP before surgery and 24 hours after surgery (p = 0.034; p = 0.0016); SIRI (systemic inflammatory response index) before surgery (p = 0.048); AISI (composite index of systemic inflammation) before surgery (p = 0.048).

Conclusion. The study showed the high diagnostic and prognostic role of new biomarkers of inflammation (high-sensitivity C-reactive protein (hs-CRP), fractalkine, IL-1β, neopterin, SIRI, AISI), determined their prognostically significant levels, which can be used as predictors of shunt dysfunction and negative outcomes of myocardial revascularization. The developed prognostic models and diagnostically significant levels of biomarkers made it possible to propose a stratification algorithm and measures to reduce the risk of developing coronary conduit dysfunction in patients after CABG.

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About Authors

  • Yuriy I. Buziashvili, Dr. Med. Sci., Professor, Academician of RAS, Head of Department, Cardiologist; ORCID
  • Inna V. Koksheneva, Dr. Med. Sci., Senior Researcher, Cardiologist; ORCID
  • Evgeniy P. Golubev, Cand. Med. Sci., Senior Researcher, Cardiovascular Surgeon; ORCID
  • Elvina F. Tugeeva, Dr. Med. Sci., Senior Researcher, Cardiologist; ORCID
  • Atabi Sh. Iraskhanov, Postgraduate, Cardiologist; ORCID
  • Uvays S. Avkhadov, Junior Researcher, Cardiovascular Surgeon; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery