Browsing by Author "Isenovic, R.E. (14040488600)"

We evaluated the prognostic value of copeptin levels in a cohort of surgical patients after elective carotid endarterectomy (CEA). Twenty-one patients with perioperative stroke were prospectively recruited. The diagnosis of cerebrovascular event (CVE) was confirmed by computed tomography. Additionally, 21 patients with CEA without any complications (control patients) were enrolled. Blood samples were taken within 3 hours of the symptom onset. Circulating copeptin level was significantly higher in patients with CVE when compared to controls (P =.025), and significantly higher in nonsurvivors than in survivors (P =.030) after CVE. Plasma concentrations of interleukin 6 (IL-6) and C-reactive protein (CRP) were also elevated in patients with CVE (IL-6: P =.043; CRP: P =.002). We conclude that the activation of the stress axis in patients with CEA results with copeptin elevation, but more so in patients with perioperative stroke. Copeptin may be a helpful biomarker for stroke risk assessment in patients after CEA. © The Author(s) 2013.

Background: Procalcitonin (PCT) is a marker for sepsis diagnosis, identification of bacterial infection and monitoring of antibiotic therapy. It has been shown that PCT is not a good choice in patients with hemodialysis. Therefore, we have explored two biomarkers: a) presepsin, and, b) midregion-proadrenomedullin (MR-proADM) in patients having End-Stage Renal Disease (ESRD). Patients and Methods: We prospectively enlisted 20 patients, who underwent cardiovascular surgery and had been on dialysis. The diagnosis of sepsis has been established clinically and confirmed by PCT. Blood samples were taken before and after dialysis. Additionally, plasma and sera of 10 healthy blood donors without any complications were used as controls. Results: Presepsin plasma concentrations (4368 ± 3088 vs. 694.1 ± 239.1 pg/mL) were significantly higher in patients with sepsis compared with controls (p<0.0001), but without significance between survivors and nonsurvivors (p=0.77). Circulating levels of MR-proADM (4.15 ± 2.72 vs. 0.294 ± 0.03 nmol/L) were also elevated in ESRD patients (p>0.05) with no significance between alive and deceased (p=0.53) patients. Adjustments have shown that the difference for MR-proADM level is due to the random sampling variability (p=0.989), whereas difference for presepsin remained highly significant (p<0.001). Conclusions: Our results indicate that the accuracy of new biomarkers is equal to that of PCT in patients with ESRD. Presepsin might be as good marker in repeated measurements, before and after dialysis, as it is PCT. © 2014 Maravic-Stojkovic V, et al.