Simultaneous determination of multiple cytokines reveals a pro-inflammatory and pro-angiogenic signature after major cardiothoracic surgery: potential role of C-reactive protein

Many studies have shown that C-reactive protein (CRP) is associated with increased cardiovascular risk. Elevated concentrations of CRP are associated with increased risk of coronary events and mortality in patients with coronary artery disease (CAD), in other high-risk individuals, and apparently in healthy people, independently from other cardiovascular risk factors. Although CRP has traditionally been considered to be a nonspecific acute phase reactant, CRP accumulates in the macrophage rich areas of the atherosclerotic plaque and modulates the expression and release of macrophage derived pro-inflammatory cytokines. In patients with stable or unstable angina, plasma concentrations of CRP >3 mg/l are associated with an increased risk of coronary events. On these bases, we have investigated the circulating levels of CRP and of a panel of 27 pro-inflammatory cytokines/chemokines in patients before and after major cardiothoracic (elective coronary bypass) surgery.