Vascular ; :Jan Here we aimed to explore the temporal profile of the stress marker cortisol and its relationship to high-sensitivity troponin-T, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, and SB as an indicator of blood-brain barrier alteration in the systemic circulation.
METHODS: Prospective part of the study: a total of 31 patients with significant carotid stenosis scheduled for carotid endarterectomy in regional anesthesia were enrolled.
Follow-up part of the study and retrospective analysis of the outcome: each patient was followed up to five years and morbidity as well as mortality data were collected from an electronic database.
Blood samples from each patient were serially taken; prior to surgery T1at the time of reperfusion T224 h T3 and 72 h later postoperatively T4then the plasma concentration of each biomarker was measured.
Besides, the clinical and surgical factors and perioperative adverse events were recorded. Five patients needed an intraoperative shunt in whom the high-sensitivity troponin-T was elevated even prior to surgery, but definitive stroke never occurred.
An early elevation of cortisol was found to be associated with a delayed increase of matrix metalloproteinase Importantly, an increased high-sensitivity troponin-T even prior to carotid endarterectomy may predict clamp rossz cardiogram hipertónia, and elevated matrix metalloproteinase-9 at reperfusion suggests a poor outcome.