Preoperative statin therapy and infectious complications in cardiac surgery

Background. Cardiac surgery in combination with hypothermia, ischaemia and reperfusion leads to an inflammatory response causing postoperative complications. Toll-like receptors are signalling molecules through which some functions of innate immunity can be activated, and polymorphic variants in the TLR-family genes can be predictors of complications after cardiac surgery. Aim. To study the associations of TLR-family genes with infectious and non-infectious complications of cardiac surgery for congenital heart defects. Methods. The study included 89 children (44 girls and 45 boys) with congenital heart defects who underwent cardiac surgery. Complications occurred in 47 children 47 days after cardiac surgery. There were no complications in 42 children. Genotyping was performed by real-time PCR using TaqMan probes. Results. A two-locus model of gene-gene interaction between TLR1 rs5743551 and TLR2 rs3804099 was the best fit, accounting for 4.01% of phenotypic entropy. The TLR2 gene polymorphic variant rs5743708 had the highest predictive potential (2.59%). Conclusion. The development of postoperative complications of cardiac surgical treatment for congenital heart defects can be due to the synergistic effect of the polymorphic variants rs5743551 in the TLR1 gene and rs3804099 in the TLR2 gene. This effect occurs through the features of TLR1 and TLR2 transcription, the subsequent expression of receptors on cells and signalling which activates the synthesis of proinflammatory cytokines and chemokines.Received 25 February 2021. Revised 11 May 2021. Accepted 12 May 2021.Funding: The work is supported by the complex program of fundamental research of the Siberian Branch of the Russian Academy of Sciences (No. 0554-2019-0002).Conflict of interest: The authors declare no conflicts of interests.Contribution of the authors Conception and study design: A.V. Shabaldin, A.V. Ponasenko, A.V. Tsepokina Data collection and analysis: A.A. Anikeenko, A.V. Tsepokina, S.A. Shmulevich Statistical analysis: A.V. Shabaldin, A.V. Tsepokina Drafting the article: A.V. Shabaldin, A.V. Tsepokina, A.V. Ponasenko Critical revision of the article: A.V. Tsepokina Final approval of the version to be published: A.V. Tsepokina, A.A. Anikeenko, S.A. Shmulevich, A.V. Ponasenko, A.V. Shabaldin

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Preoperative statins and infectious complications following cardiac surgery

Current Medical Research and Opinion ◽

10.1185/030079907x210570 ◽

2007 ◽

Vol 23 (8) ◽

pp. 1783-1790 ◽

Cited By ~ 46

Author(s):

Craig I. Coleman ◽

Diana M. Lucek ◽

Jonathan Hammond ◽

C. Michael White

Keyword(s):

Cardiac Surgery ◽

Infectious Complications

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A meta-analysis of controlled studies of preoperative statin therapy for prevention of postoperative mortality in cardiac surgery

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2009.05.027 ◽

2009 ◽

Vol 138 (3) ◽

pp. 790-791 ◽

Cited By ~ 7

Author(s):

Hisato Takagi ◽

Takuya Umemoto

Keyword(s):

Cardiac Surgery ◽

Statin Therapy ◽

Meta Analysis ◽

Postoperative Mortality

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Perioperative statin therapy reduces mortality in normolipidemic patients undergoing cardiac surgery

Yearbook of Anesthesiology and Pain Management ◽

10.1016/j.yane.2010.12.031 ◽

2011 ◽

Vol 2011 ◽

pp. 81-82

Author(s):

G.P. Gravlee

Keyword(s):

Cardiac Surgery ◽

Statin Therapy

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Hyperglycemic Episodes Are Associated With Postoperative Infections After Cardiac Surgery

Scandinavian Journal of Surgery ◽

10.1177/1457496917731190 ◽

2017 ◽

Vol 107 (2) ◽

pp. 138-144 ◽

Cited By ~ 3

Author(s):

K. M. Järvelä ◽

N. K. Khan ◽

E. L. Loisa ◽

J. A. Sutinen ◽

J. O. Laurikka ◽

...

Keyword(s):

Cardiac Surgery ◽

Blood Glucose ◽

Surgical Site Infections ◽

Infectious Complications ◽

Target Range ◽

Deep Sternal Wound Infection ◽

Postoperative Infections ◽

Glucose Levels ◽

Arterial Blood ◽

Blood Glucose Levels

Background and Aims: To describe the incidence of and risk factors for postoperative infections and the correlation between postoperative hyperglycemia despite tight blood glucose control with infectious and other complications after contemporary cardiac surgery. Material and Methods: The study comprised 1356 consecutive adult patients who underwent cardiac surgery between January 2013 and December 2014 and were followed up for 6 months. Patients surviving the first 2 days were included in the analysis. Preoperative demographic information, medical history, procedural details, and the postoperative course were recorded. The target range for blood glucose levels was 4–7 mmol/L and repeated arterial blood samples were obtained during the intensive care unit stay. The associations of blood glucose levels during the first postoperative day and the occurrence of postoperative infections and other significant complications were analyzed. Results: Of the study cohort, 9.8% developed infectious complications which were classified as major surgical site infections in 2.2%, minor surgical site infections in 1.1%, lung infections in 2.0%, unclear fever or bacteremia in 0.3%, cannula or catheter related in 2.6%, multiple in 1.5%, and other in 0.2%. The incidence of deep sternal wound infection was 2.0%. Repeated hyperglycemia occurred in 39.7% of patients and was associated with increased rates of postoperative infections, 12.1% versus 8.2%, p = 0.019; stroke, 4.9% versus 1.5%, p < 0.001; and mortality, 6.1% versus 2.1%, p < 0.001, when compared to patients with single or no hyperglycemia. Conclusion: Every 10th patient develops infectious complications after cardiac surgery. Repeated hyperglycemia is associated with increased rates of infectious complications, stroke, and mortality.

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Effect of perioperative statin therapy on renal outcome in patients undergoing cardiac surgery

Medicine ◽

10.1097/md.0000000000006883 ◽

2017 ◽

Vol 96 (19) ◽

pp. e6883 ◽

Cited By ~ 1

Author(s):

Siyang Wang ◽

Huan Yao ◽

Hong Yu ◽

Chan Chen ◽

Ronghua Zhou ◽

...

Keyword(s):

Cardiac Surgery ◽

Statin Therapy ◽

Renal Outcome

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Severity of hyperoxia as a risk factor in patients undergoing on-pump cardiac surgery

Acta medica Lituanica ◽

10.6001/actamedica.v24i3.3549 ◽

2017 ◽

Vol 24 (3) ◽

pp. 153-158

Author(s):

Gabrielius Jakutis ◽

Ieva Norkienė ◽

Donata Ringaitienė ◽

Tomas Jovaiša

Keyword(s):

Mechanical Ventilation ◽

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Hospital Stay ◽

Prolonged Mechanical Ventilation ◽

Length Of Hospital Stay ◽

Infectious Complications ◽

Research Database ◽

Elective Cardiac Surgery ◽

The Impact

Background. Hyperoxia has long been perceived as a desirable or at least an inevitable part of cardiopulmonary bypass. Recent evidence suggest that it might have multiple detrimental effects on patient homeostasis. The aim of the study was to identify the determinants of supra-physiological values of partial oxygen pressure during on-pump cardiac surgery and to assess the impact of hyperoxia on clinical outcomes. Materials and methods. Retrospective data analysis of the institutional research database was performed to evaluate the effects of hyperoxia in patients undergoing elective cardiac surgery with cardiopulmonary bypass, 246 patients were included in the final analysis. Patients were divided in three groups: mild hyperoxia (MHO, PaO2 100–199 mmHg), moderate hyperoxia (MdHO, PaO2 200–299 mmHg), and severe hyperoxia (SHO, PaO2 >300 mmHg). Postoperative complications and outcomes were defined according to standardised criteria of the Society of Thoracic Surgeons. Results. The extent of hyperoxia was more immense in patients with a lower body mass index (p = 0.001) and of female sex (p = 0.005). A significant link between severe hyperoxia and a higher incidence of infectious complications (p – 0.044), an increased length of hospital stay (p – 0.044) and extended duration of mechanical ventilation (p < 0.001) was confirmed. Conclusions. Severe hyperoxia is associated with an increased incidence of postoperative infectious complications, prolonged mechanical ventilation, and increased hospital stay.

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