Key result
Following cardiovascular implantable electronic device placement, C-reactive protein levels showed a significant upward trend, peaking between 48 and 72 hours post-procedure (β 0.208, p<0.001).
Why the study?
Data were lacking regarding the spontaneous progression of inflammatory biomarkers early after cardiovascular implantable electronic device placement.
Observational (n=153)
No
CRP levels naturally peak 48-72 hours after CIED implantation, especially in older patients and after procedures lasting >1 hour, which should be considered when evaluating for early device infections.
Answers are grounded in this paper and cite their sources.
Post-CIED CRP rise may confound early infection assessment; hypothesis-generating for inflammatory marker timing in device procedures.
Objective: There is a lack of data in the current literature regarding the spontaneous progression of inflammatory biomarkers early after cardiovascular implantable electronic device (CIED) placement. In our study we aimed to detect C-reactive protein (CRP) and white blood cell count (WBC) trends in the 5 days following CIED implantation. Methods: We retrospectively investigated a total of 235 patients who received CIEDs between 2012 and 2016 in our heart center. The levels of CRP and WBC for one day before and for the following 5 days after the procedure were noted in 4 serial measurements. The longitudinal course of CRP and WBC and their association with various parameters were analyzed with linear mix model of repeated measurements. Results: Totally 235 patients were screened; 36 patients excluded due to lack of serial CRP and WBC measurements, 44 patients excluded due to occurrence of a factor that may potentially affect CRP and WBC level. Finally 153 patients with a median age of 67 (IQR 58-74), 41 (26.8%) of whom were female, were included in the study. CRP values indicated a significant trend and made a peak in the second estimation (between 48-72 hours) after the procedure (Beta[β]: 0.208; Standard Error [S.E]: 0.015; p< 0.001). Age and procedure duration longer than 1 hour emerged as leading factors for high level of CRP (β:0.004; S.E: 0.002; p=0.05 and β: 0.208; S.E: 0.015; p= 0.02, respectively). The relation between time and WBC count was not statically significant (β: -0.129; S.E: 0.06; p=0.06). Conclusion: Progression of CRP after CIED implantation demonstrates a significant trend. Age and procedure duration longer than 1 hour are leading factors for high levels of CRP. There is statistically non-significant relation between WBC levels and time in 5 days of procedure.
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Gülşen et al. (2020) conducted an observational in Cardiovascular implantable electronic device (CIED) placement (n=153). Cardiovascular implantable electronic device (CIED) placement vs. Baseline (pre-procedure) was evaluated on Progression of C-reactive protein (CRP) levels over 5 days (β 0.208, p=<0.001). Following cardiovascular implantable electronic device placement, C-reactive protein levels showed a significant upward trend, peaking between 48 and 72 hours post-procedure (β 0.208, p<0.001).
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