Increased postoperative myeloperoxidase concentration associated with low baseline antioxidant capacity as the risk factor of delirium after cardiac surgery.
Delirium
antioxidant capacity
cardiac surgery
coronary-artery bypass graft surgery
myeloperoxidase
Journal
Annals of medicine
ISSN: 1365-2060
Titre abrégé: Ann Med
Pays: England
ID NLM: 8906388
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
entrez:
17
2
2022
pubmed:
18
2
2022
medline:
22
3
2022
Statut:
ppublish
Résumé
Though risk factors of postoperative delirium are well described, its pathophysiology is still undiscovered. The primary objective of the current study is to assess whether increased pre- and postoperative myeloperoxidase (MPO) levels are associated with postoperative delirium in the population of cardiac surgery patients. The secondary objective is to evaluate the correlation between MPO levels and serum antioxidant capacity (AC). The patients' cognitive status was assessed one day preoperatively with the use of the Mini-Mental State Examination Test and the Clock Drawing Test. A diagnosis of major depressive disorder and anxiety disorders was established based on DSM-5 criteria. Blood samples for MPO and AC levels were collected both pre- and postoperatively. The Confusion Assessment Method for the Intensive Care Unit was used to screen for a diagnosis of delirium. Delirium occurred in 34% (61 of 177) of patients. Multivariable logistic regression analysis revealed that increased postoperative MPO concentration was independently associated with postoperative delirium development, and negatively correlated with lower baseline serum AC. Cardiac surgery patients with less efficient antioxidative mechanisms experience a higher postoperative peak of serum MPO, which in turn may predispose to postoperative delirium development.KEY MESSAGESMPO is a lysosomal enzyme with strong pro-oxidative and pro-inflammatory properties.Cardiac surgery patients who have increased concentration of postoperative MPO are at significantly higher risk of postoperative delirium development.This higher level of postoperative MPO is negatively correlated with baseline antioxidant capacity (AC).It can be hypothesized that individuals with decreased baseline AC experience a higher peak of MPO post-surgery due to less efficient antioxidative mechanisms, which in turn contributes to postoperative delirium development.
Sections du résumé
BACKGROUND
BACKGROUND
Though risk factors of postoperative delirium are well described, its pathophysiology is still undiscovered. The primary objective of the current study is to assess whether increased pre- and postoperative myeloperoxidase (MPO) levels are associated with postoperative delirium in the population of cardiac surgery patients. The secondary objective is to evaluate the correlation between MPO levels and serum antioxidant capacity (AC).
METHODS
METHODS
The patients' cognitive status was assessed one day preoperatively with the use of the Mini-Mental State Examination Test and the Clock Drawing Test. A diagnosis of major depressive disorder and anxiety disorders was established based on DSM-5 criteria. Blood samples for MPO and AC levels were collected both pre- and postoperatively. The Confusion Assessment Method for the Intensive Care Unit was used to screen for a diagnosis of delirium.
RESULTS
RESULTS
Delirium occurred in 34% (61 of 177) of patients. Multivariable logistic regression analysis revealed that increased postoperative MPO concentration was independently associated with postoperative delirium development, and negatively correlated with lower baseline serum AC.
CONCLUSIONS
CONCLUSIONS
Cardiac surgery patients with less efficient antioxidative mechanisms experience a higher postoperative peak of serum MPO, which in turn may predispose to postoperative delirium development.KEY MESSAGESMPO is a lysosomal enzyme with strong pro-oxidative and pro-inflammatory properties.Cardiac surgery patients who have increased concentration of postoperative MPO are at significantly higher risk of postoperative delirium development.This higher level of postoperative MPO is negatively correlated with baseline antioxidant capacity (AC).It can be hypothesized that individuals with decreased baseline AC experience a higher peak of MPO post-surgery due to less efficient antioxidative mechanisms, which in turn contributes to postoperative delirium development.
Identifiants
pubmed: 35175161
doi: 10.1080/07853890.2022.2039405
pmc: PMC8856092
doi:
Substances chimiques
Antioxidants
0
Peroxidase
EC 1.11.1.7
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
610-616Références
Br J Pharmacol. 2007 Nov;152(6):838-54
pubmed: 17592500
J Alzheimers Dis. 2014;39(3):557-64
pubmed: 24217274
Int J Sports Med. 2012 Dec;33(12):1034-8
pubmed: 22855218
Crit Care. 2013 Mar 01;17(2):R38
pubmed: 23452669
Dement Geriatr Cogn Disord. 2014;38(1-2):65-78
pubmed: 24603477
Cell Tissue Res. 2017 Sep;369(3):445-454
pubmed: 28466093
Crit Care Med. 2001 Jul;29(7):1370-9
pubmed: 11445689
Arch Neurol. 1989 Apr;46(4):391-4
pubmed: 2705898
BMC Psychiatry. 2020 Oct 7;20(1):496
pubmed: 33028273
J Clin Biochem Nutr. 2011 Jan;48(1):8-19
pubmed: 21297906
J Clin Med. 2021 Apr 09;10(8):
pubmed: 33918634
J Gerontol A Biol Sci Med Sci. 2015 Oct;70(10):1289-95
pubmed: 26215633
Crit Care Med. 2013 Apr;41(4):999-1008
pubmed: 23385102
J Psychiatr Res. 1975 Nov;12(3):189-98
pubmed: 1202204
Mediators Inflamm. 2008;2008:135625
pubmed: 18382609
J Card Surg. 2005 Nov-Dec;20(6):560-7
pubmed: 16309412
Int Psychogeriatr. 2014 May;26(5):845-55
pubmed: 24345656
Circulation. 2003 Sep 23;108(12):1440-5
pubmed: 12952835
Int J Geriatr Psychiatry. 2019 Oct;34(10):1438-1446
pubmed: 31058343
Clin Cancer Res. 2007 Sep 15;13(18 Pt 1):5436-45
pubmed: 17875773
J Neuropsychiatry Clin Neurosci. 2010 Fall;22(4):426-32
pubmed: 21037128
Clin Interv Aging. 2018 May 30;13:1061-1070
pubmed: 29881262
N Engl J Med. 2016 Apr 21;374(16):1511-20
pubmed: 27040723