Pilot Study of Changes in Presepsin Concentrations Compared With Changes in Procalcitonin and C-Reactive Protein Concentrations After Cardiovascular Surgery

J Cardiothorac Vasc Anesth. 2017 Aug;31(4):1262-1267. doi: 10.1053/j.jvca.2017.02.007. Epub 2017 Feb 3.


Objective: The authors investigated the presepsin-concentration profile after cardiac surgery compared with those of procalcitonin (PCT) and C-reactive protein (CRP).

Design: A single-center, prospective, observational clinical study.

Setting: Hirosaki University Hospital.

Participants: Patients who underwent cardiovascular surgery without preoperative infection and end-stage kidney disease requiring dialysis. The patients also were subdivided into 2 groups with respect to the use of cardiopulmonary bypass (CPB).

Measurements and main results: Presepsin, PCT, and CRP were measured 4 times: before the induction of anesthesia (baseline), postoperative day (POD) 0, POD 1, and POD 2. Data are expressed as median (25th, 75th interquartiles). A total of 33 patients were examined: 22 patients with CPB and 11 without CPB. For the entire patient series, the presepsin concentrations on POD 0 (220 [166-445] pg/mL), POD 1 (328 [210-581] pg/mL), and POD 2 (310 [202-368] pg/mL) were increased significantly (p < 0.05) compared with baseline (176 [123-275] pg/mL). The PCT and CRP concentrations on POD 1 (0.57 [0.27-1.29] ng/mL and 5.4 [3.1-8.8] mg/dL) and POD 2 (0.64 [0.33-1.43] ng/mL and 11.8 [4.4-17.0] mg/dL) also were increased significantly (p < 0.05) compared with baseline (0.04 [0.03-0.06] ng/mL and 0.07 [0.03-0.22] mg/dL). However, the median concentrations of presepsin up to POD 2 were less than the reported cut-off value (600 pg/mL) to detect infections, whereas those of PCT were above the reported cut-off value (0.5 ng/mL). The increases in presepsin and PCT concentrations were independent of the use of CPB.

Conclusions: Cardiovascular surgery significantly increased presepsin concentrations, earlier than PCT and CRP.

Keywords: C-reactive protein; cardiopulmonary bypass; cardiovascular surgery; presepsin; procalcitonin.

Publication types

  • Clinical Trial
  • Comparative Study
  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Calcitonin / blood*
  • Cardiac Surgical Procedures / adverse effects
  • Cardiac Surgical Procedures / trends*
  • Female
  • Humans
  • Lipopolysaccharide Receptors / blood*
  • Male
  • Middle Aged
  • Peptide Fragments / blood*
  • Pilot Projects
  • Prospective Studies


  • Biomarkers
  • Lipopolysaccharide Receptors
  • Peptide Fragments
  • presepsin protein, human
  • Calcitonin
  • C-Reactive Protein