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  • Title: Preoperative plasma levels of soluble tumor necrosis factor receptor type I (sTNF-RI) predicts adverse events in cardiac surgery.
    Author: Gelape CL, Sanches MD, Teixeira AL, Teixeira MM, Bráulio R, Pinto IF, Galdino F, Ribeiro AL.
    Journal: Cytokine; 2007 May; 38(2):90-5. PubMed ID: 17600726.
    Abstract:
    OBJECTIVE: The objective was to estimate the sTNF-RI preoperative measure in the identification of patients with bad outcome and death. METHODS: We assessed prospectively sixty-two patients submitted electively to myocardial revascularization with ECC or heart valve surgery. The sTNF-RI levels were determined by the Sandwich-Type ELISA method before anesthetic induction. Clinical, surgical characteristics and sTNF-RI levels were compared among patients with good (group I, n=46) or bad outcome (group II, n=16--length of stay in the ICU for over 72 h or death). RESULTS: No difference was found between the verified mortality (6.4%) and the predicted by EuroSCORE (3.0%), p=0.48. The sTNF-RI levels were higher in group II (1322) than group I (748) p=0.009 (levels >954, 69% sensitivity and 70% specificity for good outcome, 44% positive predicted value and 85% negative). The sTNF-RI levels were higher in patients who died (1556) versus (759) p=0.029, (levels >1230, 79% sensitivity, 75% specificity, 20% positive predicted value and 98% negative). In the multivariate logistic regression model sTNF-RI (OR=1.002, IC95% 1.000-1.005, p=0.014) and age (OR=1.083, IC95% 1.010-1.161, p=0.025) were independently related to the risk of bad outcome. CONCLUSIONS: Basal levels of sTNF-RI yield prognostic information in patients who undergo heart surgery.
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