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24 February 2014 : Clinical Research  

Carotid surgery affects plasma kynurenic acid concentration: A pilot study

Piotr TerleckiABFG, Adam IwaniukBCF, Paulina PawlikBCF, Tomasz KockiADFG, Stanisław PrzywaraBG, Marek IlzeckiBG, Tomasz ZubilewiczABG, Michał KowalczykBCF, Jolanta Parada-TurskaADEF, Wojciech DąbrowskiACDEF

DOI: 10.12659/MSM.890212

Med Sci Monit 2014; 20:303-310


BACKGROUND: An increase in plasma kynurenic acid (KYNA) concentration has been observed following surgery, inflammation, and cerebral pathologies. The aim of the present study was to analyze the changes in plasma KYNA concentration in patients undergoing carotid surgery (CS).

MATERIAL AND METHODS: Adult patients undergoing elective carotid endarterectomy (CEA) or carotid angioplasty with stent placement (CAS) were studied. Plasma KYNA concentrations were analyzed before surgery and at 4 time points after CS. The amount of inflammation was measured as neutrophil-lymphocyte ratio (NLR).

RESULTS: Forty patients (10 female and 30 male) aged 55–86 years of age were evaluated in this study. In patients with unstable carotid plaque, the plasma KYNA concentration was higher than in patients with stable carotid plaque. Moreover, the NLR was significantly higher in patients with unstable carotid plaque undergoing CEA than in patients undergoing CAS. Plasma KYNA concentration increased after surgery in patients undergoing CEA and CAS. There was a strong correlation between plasma KYNA concentration and NLR in patients with postoperative neurological disorders.

CONCLUSIONS: CS increases plasma KYNA concentration, and changes in plasma KYNA concentration can indicate neurologic outcomes in patients undergoing CS.

Keywords: kynurenic acid, Endarterectomy, Carotid, Aged, 80 and over, Analysis of Variance, Angioplasty - adverse effects, Carotid Arteries - surgery, Endarterectomy, Carotid - adverse effects, Kynurenic Acid - blood, Lymphocytes, Neutrophils, Plaque, Atherosclerotic - surgery

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750