Cardiac Biomarkers and Prediction of Early Outcome After Heart Valve Surgery: A Prospective Observational Study.

[en] OBJECTIVES: Circulating cardiac biomarkers may improve the prediction of long-term outcomes after cardiac surgery. The authors sought to assess if cardiac biomarkers also help better predict short-term morbidity. DESIGN: Prospective observational study. SETTING: Single academic hospital. PARTICIPANTS: A total of 250 patients undergoing aortic or mitral valve surgery with or without associated coronary artery bypass grafts. INTERVENTION: None MEASUREMENT AND MAIN RESULTS: Relationships between preoperative plasma concentrations of four cardiac biomarkers (sST2, Galectin-3, GDF-15, and NT-proBNP) and postoperative outcome were assessed using logistic regressions and Cox proportional hazards models. The primary outcome was a composite of 30-day mortality, an inotropic support longer than 48 hours and an initial length of stay in the intensive care >five days. Secondary outcome measures were postoperative acute kidney injury, inotropic support duration, lengths of intensive care unit and hospital stays, and 30-day and one-year mortality. No association was observed between any of the four cardiac biomarkers and the primary outcome. The preoperative levels of Galectin-3 (hazard ratio = 1.2; p < 0.001) and sST2 (hazard ratio = 1.01, p < 0.001) were significantly associated with one-year survival, and their addition to the EuroSCORE II significantly improved the prediction of one-year mortality (p < 0.001). Similarly, Galectin-3 was associated with postoperative acute kidney injury (odds ratio = 1.15, p = 0.001) and improved the prediction of this complication when added to the EuroSCORE II (p = 0.002). CONCLUSIONS: These results suggested that the ability of cardiac biomarkers to predict short-term outcome after cardiac surgery, though of interest, appears limited. Conversely, cardiac biomarkers may have the potential to refine the prediction of long-term outcome. Admittedly, all positive results were obtained on secondary outcomes and must be regarded with caution.

Disciplines :

Anesthesia & intensive care

Author, co-author :

Wozolek, Aaron

Jaquet, Oceane

Donneau, Anne-Françoise

Lancellotti, Patrizzio

Le Goff, Caroline ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale

Cavalier, Etienne ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale

Radermecker, Marc ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Anatomie humaine

Lavigne, Jean-Paul

Durieux, Rodolphe ; Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques

Roediger, Laurence

More authors (5 more)

Language :

English

Title :

Cardiac Biomarkers and Prediction of Early Outcome After Heart Valve Surgery: A Prospective Observational Study.

Publication date :

2022

Journal title :

Journal of Cardiothoracic and Vascular Anesthesia

ISSN :

1053-0770

eISSN :

1532-8422

Publisher :

W. B. Saunders Co., United Kingdom

Peer reviewed :

Peer Reviewed verified by ORBi

Commentary :

Available on ORBi :

since 07 December 2021

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