Diagnostic usefulness of inflammatory markers in acute cellular rejection after heart transplantation

被引:7
作者
Sanchez-Soriano, R. M.
Almenar, L.
Martinez-Dolz, L.
Reganon, E.
Martinez-Sales, V.
Chamorro, C. I.
Vila, V.
Martin-Pastor, J.
Villa, P.
Salvador, A.
机构
[1] Univ Valencia, Hosp La Fe, Dept Cardiol, Cardiac Failure & Transplant Unit, Valencia 46009, Spain
[2] Univ Valencia, Hosp La Fe, Res Ctr, Valencia 46009, Spain
关键词
D O I
10.1016/j.transproceed.2006.09.002
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Acute cellular rejection (ACR) affects early morbidity and mortality after heart transplantation. The diagnostic technique of choice is endomyocardial biopsy. Our aim was to evaluate the diagnostic usefulness of inflammatory markers as a noninvasive method to monitor cellular rejection. Material and Methods. We prospectively analyzed 73 cardiac transplant patients by determining the serum levels of protein fibrinogen (fgpro), functional fibrinogen (fgfun), C-reactive protein (CRP), and sialic acid (SA) coinciding with an endomyocardial biopsy (5.1 revisions/patient). The statistical methods were chi(2), Student's t-test, and ROC curves. Results. Of the 373 controls, significant rejection was detected in 19%. Analysis of the relationship between ACR and the markers showed significantly elevated levels of fgpro (345 +/- 90 versus 307 +/- 74 mg/dL; P = .03), fgfun (361 +/- 101 versus 318 +/- 89 mg/dL; P = .04), and SA (74 +/- 22 versus 66 +/- 15 mg/dL; P = .02), but not CRP (19 +/- 29 versus 10 +/- 21 mg/dL; P = .07). SA displayed a better diagnostic utility (area under the curve 0.7; P < .01), 35% sensitivity, 85% specificity, and 82% negative predictive value for a cutoff point of 80 mg/dL. Conclusions. Among the inflammatory markers increased in ACR, SA was the most useful noninvasive tool for screening.
引用
收藏
页码:2569 / 2571
页数:3
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