Biomarkers in Coronary Artery Bypass Surgery: Ready for Prime Time and Outcome Prediction?

Abstract

Coronary artery bypass surgery (CABG) is still one of the most frequently performed surgical procedures all over the world. The results of this procedure have been constantly improved over the years with low perioperative mortality rates, with relatively low complication rates. To further improve these outstanding results, the clinicians focused their attention at biomarkers as outcome predictors. Although biological testing for disease prediction has already been discussed many times, the role of biomarkers in outcome prediction after CABG is still controversial. In this article, we reviewed the current knowledge regarding the role of genetic and dynamic biomarkers and their possible association with the occurrence of adverse clinical outcomes after CABG. We also took into consideration that the molecular pathway activation and the possible imbalance may affect hard outcomes and graft patency. We analyzed biomarkers classified in two different categories depending on their possibility to change over time: genetic markers and dynamic markers. Moreover, we evaluated these markers by dividing them, into sub-categories, such as inflammation, hemostasis, renin–angiotensin, endothelial function, and other pathways. We showed that biomarkers might be associated with unfavorable outcomes after surgery, and in some cases improved outcome prediction. However, the identification of a specific panel of biomarkers or of some algorithms including biomarkers is still in an early developmental phase. Finally, larger studies are needed to analyze broad panel of biomarkers with the specific aim to evaluate the prediction of hard outcomes and graft patency.

Development of a novel UHPLC-MS/MS-based platform to quantify amines, amino acids and methylarginines for applications in human disease phenotyping

“…Samples were collected before and after bypass surgery from a cohort of 20 patients. As we 21 and others 22 have shown, cardiopulmonary bypass, by virtue of the invasive nature of the surgery and the requirement for bypass intervention, invariably results in some degree of ‘systemic inflammation’. In this cohort 18 of the patients developed clinically relevant SIRS (see Supplementary Table 2 ), of which for one patient (patient 1; see Supplementary Table 2 ) an incomplete sample range was obtained.…”

Plasma levels of matrix metalloproteinase 9 in patients undergoing off-pump coronary artery bypass grafting

“…Perioperative myocardial injury has been thought as a kind of serious complication for CABG, which is also related to a high level of morbidity and mortality during a long period (13). Under the circumstance that no effective pharmacological therapy can be used to treat the perioperative myocardial, but early preventive measures, like pre-OP risk predication and perioperative optimization, could be a good choice in reducing the myocardial injury to some degree (14). What's more, due to a novel biomarker, myocardial injury prediction is of great use in providing the valuable information in the management during the perioperative period (15).…”

The correlation between preoperative erythrocyte sedimentation rate and postoperative outcome in adult cardiac surgery

“…Togan et al7 recently reported that preoperative elevation of ESR is a risk factor for the postcoronary artery bypass graft (post-CABG) complication in male patients. Similarly, Parolari et al12 stated that increased levels of other similar biomarkers such as IL-1 and CRP are associated with the unfavorable outcome following CABG. The primary purpose of the present study was to investigate the relationship between elevated levels of preoperative ESR and short- and mid-term outcome and postoperative complications in adult heart operations.…”