Clinical Medicine Insights: Cardiology · Published 2026-07-01 · DOI 10.1177/11795468261462607
Krzysztof Laudanski, Ahmed Sayed Ahmed, Mohamed A. Mahmoud, Hossam Gad, Benjamin R.E. Harris, Ryan Smith, Dandan Zhu, Abdelhamed Elgazar, Anil Vasishta, Gajic Ognjen, Daniel A. Diedrich, Juan Crestanello
Variability in novel inflammatory markers (HBP and SAA) post-surgery could indicate ongoing perioperative inflammation. This pilot cohort study collected blood from 99 patients undergoing elective cardiac surgery at baseline, 24 hours, 7 days, and 3 months post-surgery. Inflammatory markers (HBP, SAA, PCT, CRP, IL-6) were measured with a point-of-care device. Demographic and clinical data were extracted from health records. Serum SAA increased significantly in the acute postoperative phase (M e [IQR];SAA baseline =81.1[87] vs SAA 24hr= 232.65[88.02];U[72]=2343,p<0.0001), remained elevated at 7 days (Me 7d =252.6[88.56];U[57]=1484,p<0.0001) and were still more pronounced than baseline at t 3m (Me 3m =118.44[101.52];U[38]=448,p=0.0008). HBP showed a significant rise at seven days (HBP baseline =45[26;89] vs HBP 7d =121[69.75;224.5]; U[56]=805,p<0.0001) then returned to near baseline by t 3m (Me 3m =32.5[15.75;98.5]). Traditional inflammatory markers PCT, CRP, and IL-6 demonstrated a rapid increase at t 24h and plateaued at t 7d . None of the biomarkers showed variability at baseline or postoperatively with preoperative status or postoperative complications. Cluster analysis of the inflammatory markers at 24 hours (t 24h ) identified distinct subgroups. Cluster #1-patients with a modest increase in all markers; Cluster#2 characterized with a robust increase in IL-6; Cluster #3 showed increase in CRP and decline in HBP; Cluster #4 showed a modest increase in IL-6 and decline in HBP; Cluster #5 represented a decline in both CRP and SAA. Patients in these clusters differ with respect to age, pre-existing peripheral artery disease, and borderline differences in perioperative acetaminophen use. SAA and HBP remain elevated longer than IL-6, CRP, and PCT after surgery, suggesting that inflammation may persist beyond 3 months.
Abstract from DOAJ. Public domain (CC0 1.0).
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Laudanski, K., Ahmed, A., Mahmoud, M., et al. (2026). Longitudinal Analysis of Heparin-Binding Protein (HBP) and Serum Amyloid a Protein (SAA) Versus Interleukin 6 (IL-6), C-Reactive Protein (CRP), and Procalcitonin (PCT) During Both the Acute Postoperative Period and Recovery at Three Months From Non-emergent Cardiac Surgery. Clinical Medicine Insights: Cardiology. https://doi.org/10.1177/11795468261462607