Anna Clementi1,2, Grazia Maria Virzì3,4, María-Jimena Muciño-Bermejo1,5, Federico Nalesso5,6, Davide Giavarina7, Mariarosa Carta7, Alessandra Brocca1,5,6, Massimo de Cal1,5, Tommaso Hinna Danesi8, Monica Zanella5, Nicola Marchionna5, Alessandra Brendolan5, Giovanni Giorgio Battaglia2, Loris Salvador8, Claudio Ronco1,5. 1. IRRIV - International Renal Research Institute Vicenza, Vicenza, Italy. 2. Department of Nephrology and Dialysis, Santa Marta and Santa Venera Hospital, Acireale, Italy. 3. IRRIV - International Renal Research Institute Vicenza, Vicenza, Italygraziamaria.virzi@gmail.com. 4. Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza, Italygraziamaria.virzi@gmail.com. 5. Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza, Italy. 6. Department of Medicine - DIMED, Unit of Internal Medicine and Hepatology (UIMH), University of Padova, Padova, Italy. 7. Clinical Chemistry and Haematology Laboratory, San Bortolo Hospital, Vicenza, Italy. 8. Department of Cardiac Surgery, San Bortolo Hospital, Vicenza, Italy.
Abstract
Backgound: This study was aimed at evaluating the presepsin and procalcitonin levels to predict adverse postoperative complications and mortality in cardiac surgery patients. METHODS: A total of 122 cardiac surgery patients were enrolled for the study. Presepsin and procalcitonin levels were measured 48 h after the procedure. The primary endpoints were adverse renal, respiratory, and cardiovascular outcomes and mortality. RESULTS: Presepsin and procalcitonin levels were significantly higher in patients with adverse renal and respiratory outcome (p < 0.001 and 0.0081). The presepsin levels were significantly higher in patients with adverse cardiovascular outcome (p = 0.023) and the procalcitonin values in patients with sepsis (p = 0.0013). Presepsin levels were significantly higher in patients who died during hospitalization (382 pg/mL, interquartile range [IQR] 243-717.5 vs. 1,848 pg/mL, IQR 998-5,451.5, p = 0.049). In addition, the predictive value for in-hospital, 30-days, and 6-months mortality was higher for presepsin, with a significant difference between the 2 biomarkers (p = 0.025, p = 0.035, p = 0.003; respectively). Presepsin and procalcitonin seem to have comparable predictive value for adverse renal, cardiovascular, and respiratory outcome in cardiac surgery patients. Although a positive trend was notable for presepsin and adverse renal outcome (area under the ROC [receiver operating characteristic] curves [AUC] of 0.760, 95% CI 0.673-0.833 versus procalcitonin: AUC 0.692; 95% CI 0.601-0.773): no statistically significant difference was evident between the AUC of the 2 biomarkers (p = 0.25). CONCLUSIONS: Presepsin and -procalcitonin seem to have comparable predictive value for -adverse renal, cardiovascular, and respiratory outcome in cardiac surgery patients. Also, presepsin possesses a better predictive value for in-hospital, 30-days, and 6-months mortality.
Backgound: This study was aimed at evaluating the presepsin and procalcitonin levels to predict adverse postoperative complications and mortality in cardiac surgery patients. METHODS: A total of 122 cardiac surgery patients were enrolled for the study. Presepsin and procalcitonin levels were measured 48 h after the procedure. The primary endpoints were adverse renal, respiratory, and cardiovascular outcomes and mortality. RESULTS: Presepsin and procalcitonin levels were significantly higher in patients with adverse renal and respiratory outcome (p < 0.001 and 0.0081). The presepsin levels were significantly higher in patients with adverse cardiovascular outcome (p = 0.023) and the procalcitonin values in patients with sepsis (p = 0.0013). Presepsin levels were significantly higher in patients who died during hospitalization (382 pg/mL, interquartile range [IQR] 243-717.5 vs. 1,848 pg/mL, IQR 998-5,451.5, p = 0.049). In addition, the predictive value for in-hospital, 30-days, and 6-months mortality was higher for presepsin, with a significant difference between the 2 biomarkers (p = 0.025, p = 0.035, p = 0.003; respectively). Presepsin and procalcitonin seem to have comparable predictive value for adverse renal, cardiovascular, and respiratory outcome in cardiac surgery patients. Although a positive trend was notable for presepsin and adverse renal outcome (area under the ROC [receiver operating characteristic] curves [AUC] of 0.760, 95% CI 0.673-0.833 versus procalcitonin: AUC 0.692; 95% CI 0.601-0.773): no statistically significant difference was evident between the AUC of the 2 biomarkers (p = 0.25). CONCLUSIONS: Presepsin and -procalcitonin seem to have comparable predictive value for -adverse renal, cardiovascular, and respiratory outcome in cardiac surgery patients. Also, presepsin possesses a better predictive value for in-hospital, 30-days, and 6-months mortality.
Authors: Silvia Gasteiger; Florian Primavesi; Peter Werkl; Lucie Dostal; Philipp Gehwolf; Eva Braunwarth; Manuel Maglione; Sieghart Sopper; Dietmar Öfner; Stefan Stättner Journal: PLoS One Date: 2020-12-09 Impact factor: 3.240