Novel inflammatory biomarkers after long-term left ventricular assist
device implantation
Abstract
Background and aim of the study: Despite progressive improvement in
perioperative care and device technology infectious complications (IC)
remain one of the main causes worsening both short-term and long-term
prognosis after long-term ventricular assist device (LVAD) implantation.
The aim of this study was to assess procalcitonin (PCT) and presepsin
(PSEP) dynamics after LVAD implantation and its relationship to IC in
the early post-operative period. Methods: A total of 50 consecutive
patients indicated to LVAD implantation were included. PCT and PSEP
levels were prospectively assessed before surgery and during 30 day
follow-up - 1st, 2nd, 14th and 30th post-operative day (POD). Values
were compared according to the presence of IC. Results: Both PCT and
PSEP levels raised significantly after LVAD implantation. There was no
significant difference in PCT or PSEP levels between patients with or
without IC during whole follow-up. Patients with acute renal failure
(ARF) had significantly higher PCT levels 2 days after surgery and
further. ARF increased PSEP levels significantly only 14 days after LVAD
implantation. Also subjects with right ventricular assist device (RVAD)
had higher PCT and PSEP values. This difference reached the significance
only for PCT 14 days after surgery. Conclusions: Our data show that
ability of PCT or PSEP to detect infectious complications in patients
after LVAD implantation is limited. Their levels more likely correlate
with severity of post-operative period in general.