DOI: https://doi.org/10.22263/2312-4156.2023.3.63
I.G. Tishkevich1, А.V. Marochkov1, V.A. Livinskaya2, А.A. Marochkov1, M.S. Kurashov1
The dynamics of serum C-reactive protein and iron concentration in patients during cardiosurgical operations
1Mogilev Regional Clinical Hospital, Mogilev, Republic of Belarus
2Belarusian-Russian University, Mogilev, Republic of Belarus
Vestnik VGMU. 2023;22(3):63-70.
Abstract.
A moderate negative correlation (R=-0.39; p<0.05) was found between increased C-reactive protein (CRP) level and decreased iron level in 24 hours after cardiosurgical operation with cardiopulmonary bypass.
Objectives. To determine the changes in serum CRP and iron concentration in open heart cardiopulmonary bypass surgery patients over time, as well as the correlation between them as the traumatism criteria after undergoing surgery.
Material and methods. A prospective non-randomised cohort study was performed. The dynamics of CRP and iron concentration was assessed in 30 adult patients admitted to the cardiac surgery department for an open heart cardiopulmonary bypass surgery. All patients gave venous blood samples at the following sampling time periods: 1 – before the surgery; 2 – in 24 hours after the start of the surgery; 3 and 4 – in 48 hours and 72 hours, respectively. CRP concentration was determined by immunoturbidimetry at the clinical biochemistry laboratory; iron concentration was determined by colorimetry with TPTZ chromogenic reagent.
Results. A phase change in CRP and iron concentration was observed during the postoperative period vs. the preoperative one. CRP concentration showed a significant increase in 24, 48, and 72 hours after the start of the surgery, which correlates with a statistically significant decrease of iron level in 24 hours after the start of the surgery (R=-0.39, p<0.05).
Keywords: cardiac surgery, C-reactive protein, iron.
Acknowledgements. The authors express their gratitude to anonymous reviewers for the time spent while working at their article.
References
1. Munos M, Villar I, Garcia-Erce JA. An update of iron physiology. World J Gastroenterol. 2009 Oct;15(37):4617-26. doi: http://dx.doi.org/10.3748/wjg.15.4617
2. Camaschella C. Iron deficiency. Blood. 2019 Jan;133(1):30-39. doi: http://dx.doi.org/10.1182/blood-2018-05-815944
3. Del Pinto R, Ferri C. Iron deficiency in heart failure: diagnosis and clinical implications. Eur Heart J. 2022 Nov;24( suppl 1):196-9. doi: http://dx.doi.org/10.1093/eurheartjsupp/suac080
4. Busti F, Marchi G, Ugolini S, Castagna A, Girelli D. Anemia and Iron Deficiency in Cancer Patients: Role of Iron Replacement Therapy. Pharmaceuticals (Basel). 2018 Sep;11(4):94. doi: http://dx.doi.org/10.3390/ph11040094
5. Cappellini MD, Comin-Colet J, de Francisco A, Dignass A, Doehner W, et al. Iron deficiency across chronic inflammatory conditions: International expert opinion on definition, diagnosis, and management. Am J Hematol. 2017 Oct;92(10):1068-78. doi: http://dx.doi.org/10.1002/ajh.24820
6. Nairz M, Theurl I, Wolf D, Weiss G. Iron deficiency or anemia of inflammation? Differential diagnosis and mechanisms of anemia of inflammation. Wien Med Wochenschr. 2016 Oct;166(13-14):411-23. doi: http://dx.doi.org/10.1007/s10354-016-0505-7
7. Stavchikov EL, Zinovkin IV, Marochkov AV, Makhnach AE, Rosinskaya MN. Dynamics of C-reactive protein in patients undergoing radical phlebectomy of the lower extremity. Zhurn GrGMU. 2020;18(4):436-40. doi: http://dx.doi.org/10.25298/2221-8785-2020-18-4-436-440 (In Russ.)
8. Rubanenko OA. Effects of coronary bypass surgery on inflammatory factors and myocardial damage in patients with coronary heart disease. Baikal Med Zhurn. 2016;140(1):18-22. (In Russ.)
9. Dudko VA, Subbotina EA, Politov IV, Lipnitskiy AV, Kulik AS, Marochkov AV. Dynamics of C-reactive protein in blood serum during anesthesiological support of surgical interventions. Vestn VGMU. 2020;19(1):59-65. doi: http://dx.doi.org/10.22263/2312-4156.2020.1.59 (In Russ.)
10. Santonocito C, Sanfilippo F, De Locker I, Chiarenza F, Giacomo C, Njimi H, et al. C-Reactive protein kinetics after cardiac surgery: A retrospective multicenter study. Ann Card Anaesth. 2022 Oct-Dec;25(4):498-504. doi: http://dx.doi.org/10.4103/aca.aca_141_21
11. Solis JV, Portero JL, Diaz J, Garcia R, Ligero JM, Vazquez E, et al. Iron Deficiency in the Acute-Phase Reaction After Open Aortic Surgery. Vasc Endovascular Surg. 2006 Oct-Nov;40(5):392-8. doi: http://dx.doi.org/10.1177/1538574406293749
12. Hoppe M, Lönnerdal B, Hossain B, Olsson S, Nilsson F, Lundberg P-A, et al. Hepcidin, interleukin-6 and hematological iron markers in males before and after heart surgery. J Nutr Biochem. 2009 Jan;20(1):11-6. doi: http://dx.doi.org/10.1016/j.jnutbio.2007.11.008
13. McSorley ST, Jones I, McMillan DC, Talwar D. Quantitative data on the magnitude of the systemic inflammatory response and its relationship with serum measures of iron status. Transl Res. 2016 Oct;176:119-26. doi: http://dx.doi.org/10.1016/j.trsl.2016.05.004
14. McSorley ST, Tham A, Jones I, Talwar D, McMillan DC. Regression Correction Equation to Adjust Serum Iron and Ferritin Concentrations Based on C-Reactive Protein and Albumin in Patients Receiving Primary and Secondary Care. J Nutr. 2019 May;149(5):877-83. doi: http://dx.doi.org/10.1093/jn/nxz008
15. Bitkover CY, Hansson LO, Valen G, Vaage J. Effects of cardiac surgery on some clinically used inflammation markers and procalcitonin. Scand Cardiovasc J. 2000 Jun;34(3):307-14. doi: http://dx.doi.org/10.1080/713783128
Information about authors:
I.G. Tishkevich – cardiac surgeon of the cardiac surgery department, Mogilev Regional Clinical Hospital, https://orcid.org/0000-0003-3616-1933
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Igor G. Tishkevich;
A.V. Marochkov – Doctor of Medical Sciences, professor, anesthesiologist-resuscitator of the anesthesiology and resuscitation department, Mogilev Regional Clinical Hospital, https://orcid.org/0000-0001-5092-8315
V.A. Livinskaya –Candidate of Physical and Mathematical Sciences, associate professor of the Chair «Finance & Accounting», Belarusian–Russian University, https://orcid.org/0000-0001-8953-8533
А.A. Marochkov –roentgenendovascular surgeon of the X-ray endovascular surgery department, Mogilev Regional Clinical Hospital, https://orcid.org/0009-0007-7405-5093
M.S. Kurashov – cardiac surgeon of the cardiac surgery department, Mogilev Regional Clinical Hospital, https://orcid.org/0000-0001-8983-2513
