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Novel inflammatory biomarkers after long-term left ventricular assist device implantation
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  • Martin Holek,
  • Jiri Kettner,
  • Janka Franekova,
  • Antonin Jabor,
  • Marian Pindak,
  • Hynek Riha,
  • Josef Kautzner,
  • Ivan Netuka,
  • Jan Pirk
Martin Holek
Institute of Clinical and Experimental medicine
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Jiri Kettner
Institute of Clinical and Experimental medicine
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Janka Franekova
Institute for Clinical and Experimental Medicine Department of Laboratory Methods
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Antonin Jabor
Institute for Clinical and Experimental Medicine Department of Laboratory Methods
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Marian Pindak
Institute of Clinical and Experimental medicine
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Hynek Riha
Institute of Clinical and Experimental medicine
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Josef Kautzner
Institute of Clinical and Experimental medicine
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Ivan Netuka
Institute of Clinical and Experimental medicine
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Jan Pirk
Institute of Clinical and Experimental medicine
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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.