Abstract
Background
Hydrocortisone may reduce serum and tissue concentrations of inflammatory biomarkers.
Objective
To analyze the inflammatory activity of serum and tissue high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor (TNF)-α and vascular endothelial growth factor (VEGF) after intraoperative administration of hydrocortisone, after carotid endarterectomy (CEA).
Method
Twenty-two patients were allocated to a Control Group (5 asymptomatic and 6 symptomatic patients) and were not administered hydrocortisone or to Group 1 (4 asymptomatic and 7 symptomatic patients) and were administered 500 mg intravenous hydrocortisone. Serum levels of hsCRP, TNF-α and VEGF were tested for the preoperative period and at 1 hour, 6 hours and 24 hours after CEA. Levels of TNF-α and VEGF were also measured in carotid plaques.
Results
Group 1 exhibited lower concentrations of serum TNF-α at 1 hour (p=0.031), 6 hours (p=0.015) and 24 hours (p=0.017) after CEA and lower concentrations of serum VEGF at 1 hour (p=0.006) and 6 hours (p=0.005) after CEA, relative to controls. Symptomatic patients in group 1 exhibited lower concentrations than controls for serum TNF-α at 1 hour and 6 hours after CEA and lower concentrations than controls for serum VEGF at 1 hour after CEA. There were no statistical differences in tissue concentrations of TNF-α or VEGF between the control group and group 1.
Conclusion
Hydrocortisone reduces postoperative concentrations of serum TNF-α and VEGF, especially in symptomatic patients; but does not reduce tissue levels of these biomarkers.
Keywords:
hydrocortisone; inflammation; carotid stenosis
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