C-Reactive protein and inflammatory response associated to neurocognitive decline following cardiac surgery

Basel Ramlawi, James L. Rudolph, Shigetoshi Mieno, Jun Feng, Munir Boodhwani, Kamal Khabbaz, Sue E. Levkoff, Edward R. Marcantonio, Cesario Bianchi, Frank W. Sellke

Research output: Contribution to journalArticle

78 Scopus citations

Abstract

Background: It has been recognized that neurocognitive decline (NCD) often occurs as a complication in cardiac surgery. The early inflammatory response and C-reactive protein (CRP) was examined in relation to NCD and to a marker of axonal central nervous system (CNS) injury after cardiopulmonary bypass. Methods: A cohort of patients undergoing coronary artery bypass grafting and/or valve procedures using cardiopulmonary bypass were administered a neurocognitive battery preoperatively and postoperatively at 6 hours and day 4. CRP, interleukin 1β, and interleukin 10 were quantified from serum. Increase of serum tau protein after surgery was used as a marker of axonal CNS damage. Results: The rate of NCD was found to be 40.5% in this group. Surprisingly, known predictors of NCD did not differ significantly between patients with/without NCD. Patients with NCD had an early increase of CRP of a significantly higher magnitude than those without NCD (38.01 ± 11.4 vs 16.49 ± 3.5 mg/L, P = .042), interleukin 1ß (2.35 ± 0.3 vs 1.20 ± 0.2 pg/mL, P = .002), and interleukin 10 (29.77 ± 4.7 vs 12.94 ± 2.2 pg/mL, P < .001). Increase in serum Tau protein was significantly correlated to NCD (r = 0.50, P = .02). Conclusion: Perioperative increases in CRP and inflammatory cytokines are associated with NCD in patients after cardiopulmonary bypass. Thus, it appears that inflammation plays a key role in NCD pathophysiology, likely via axonal CNS injury, and could become a target for prevention.

Original languageEnglish (US)
Pages (from-to)221-226
Number of pages6
JournalSurgery
Volume140
Issue number2
DOIs
StatePublished - Aug 1 2006

ASJC Scopus subject areas

  • Surgery

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