The Importance of Wnt-signaling After Cardiac Surgery

NCT ID: NCT04058496

Last Updated: 2022-07-21

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 64 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2018-11-01
• Study Completion Date: 2022-04-01

Brief Summary

Cardiac surgery saves lives when patients suffer from cardiac disease. Local inflammation is important for tissue repair and wound healing after such an operation. Inflammation starts already when the patient is treated in the intensive care unit. When inflammatory proteins (cytokines) are released into the circulation, they cause also a systemic inflammation, which alerts the immune system of the body and activates defence mechanisms (=adaptive response). In some patients, systemic inflammation is out of control thereby causing organ dysfunctions, shock, and in the most severe cases even death (=maladaptive response). The aim of this study is to investigate the early phase of inflammation after the operation. Repeated blood samples will be taken of patients undergoing cardiac surgery to describe the patterns and dynamics of inflammation proteins. A better understanding of these mechanisms will potentially lead to improved treatment of patients after cardiac surgery.

Detailed Description

The aim of this project is to understand early inflammation mechanisms after cardiac surgery. Therefore, repeated blood samples of patients undergoing cardiac surgery will be taken. Patients are selected after "open" cardiac surgery (via sternotomy), when when they require postoperative care in the cardiovascular intensive care unit. The blood samples will be analysed in collaboration with the Inflammation Research Unit of the Department of Internal Medicine at the University Hospital Zurich.

Conditions

Inflammation; Thoracic Surgery

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

1

Coronary artery bypass surgery off-pump (n=24)

Blood sampling

Intervention Type: OTHER

Five Timepoints: baseline (pre-operative), ICU admission, 4 hours after ICU admission, 8 hours after ICU admission, 48 hours after ICU admission

2

Coronary artery bypass surgery on-pump (n=16)

Blood sampling

Intervention Type: OTHER

Five Timepoints: baseline (pre-operative), ICU admission, 4 hours after ICU admission, 8 hours after ICU admission, 48 hours after ICU admission

3

Coronary artery bypass surgery plus valve surgery (n=20)

Blood sampling

Intervention Type: OTHER

Five Timepoints: baseline (pre-operative), ICU admission, 4 hours after ICU admission, 8 hours after ICU admission, 48 hours after ICU admission

Interventions

Blood sampling

Five Timepoints: baseline (pre-operative), ICU admission, 4 hours after ICU admission, 8 hours after ICU admission, 48 hours after ICU admission

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Cardiac surgery via sternotomy
• Coronary-bypass bypass surgery with or without valve surgery
• Postoperative hospitalisation in the cardio-surgical ICU
• Available informed consent

Exclusion Criteria

• Preoperative infections (e.g. endocarditis)
• Preoperative use of steroids or other immunosuppression

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Zurich

OTHER

Sponsor Role: collaborator

Alain Rudiger

OTHER

Sponsor Role: lead

Responsible Party

Alain Rudiger

Prof. Dr. med.

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

Alain Rudiger, MD

Role: PRINCIPAL_INVESTIGATOR

University of Zurich

Locations

University Hospital

Zurich, , Switzerland

Countries

Switzerland

References

Hauffe T, Kruger B, Bettex D, Rudiger A. Shock Management for Cardio-surgical ICU Patients - The Golden Hours. Card Fail Rev. 2015 Oct;1(2):75-82. doi: 10.15420/cfr.2015.1.2.75.

Reference Type: BACKGROUND

PMID: 28785436 (View on PubMed)

Hauffe T, Kruger B, Bettex D, Rudiger A. Shock Management for Cardio-surgical Intensive Care Unit Patient: The Silver Days. Card Fail Rev. 2016 May;2(1):56-62. doi: 10.15420/cfr.2015:27:2.

Reference Type: BACKGROUND

PMID: 28785454 (View on PubMed)

Kruger BD, Hofer GE, Rudiger A, Spahn GH, Braun J, Bettex D, Schoedon G, Spahn DR. Wingless-related integration site (WNT) signaling is activated during the inflammatory response upon cardiac surgery: A translational study. Front Cardiovasc Med. 2022 Nov 11;9:997350. doi: 10.3389/fcvm.2022.997350. eCollection 2022.

Reference Type: DERIVED

PMID: 36440011 (View on PubMed)

Other Identifiers

Wnt-study

Identifier Type: -

Identifier Source: org_study_id