Comparison between the level of interleukin-6 and b-type natriuretic peptide as predictors of the outcome after coronary artery bypass graft surgery

الملخص EN

Introduction The B-type natriuretic peptide (BNP) and interleukin-6 (IL-6) are increasingly being used as biomarkers for the diagnosis, management, and prognosis of complications after cardiac surgery with cardiopulmonary bypass (CPB).

The aim of this study was to assess preoperative and postoperative levels of BNP and IL-6 in patients undergoing coronary artery graft surgery (CABG) with CPB and investigate their variation and ability to correlate with immediate postoperative outcome.

Patients and Methods Patients scheduled for elective CABG with CPB were enrolled in this study.

Plasma levels of BNP and IL-6 were measured preoperatively, 6, 12, and 24 h after CPB.

The main endpoints were the correlation between the level of BNP and IL-6 and the requirements for an intra-aortic balloon pump, artifi cial ventilation for more than 24 h, intensive care unit (ICU) stay longer than 5 days, requirement for inotropic support, hospital stay, and clinical complications (infection, myocardial infarction, ventricular arrhythmias, stroke, or renal failure).

Results Sixty-eight patients (eight women and 60 men), median age 63.3 ± 6.9 years, were included in the study.

Preoperative BNP levels correlated with longer ICU stay (P = 0.003), longer mechanical ventilation (P = 0.016), and longer epinephrine and milrinone use (P < 0.001), whereas BNP at 24 h after CABG correlated only with longer epinephrine and milrinone use (r = 0.418, P = 0.003).

Preoperatively and 6 h postoperatively, IL-6 correlated with longer epinephrine and milrinone use (P = 0.018) and longer ICU stay, and was signifi cantly increased in patients with infection at all time points of measurement.

Conclusion BNP correlates with clinical endpoints more than IL-6 and both can be used together as predictors of early outcome after coronary artery bypass grafting surgery.