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Biomarkers. 2018 Dec 4:1-27. doi: 10.1080/1354750X.2018.1556338. [Epub ahead of print]

sST2 as a Novel Biomarker for the Prediction of In-hospital Mortality after Coronary Artery Bypass Grafting.

Author information

1
a The Dartmouth Institute for Health Policy & Clinical Practice , Dartmouth Geisel School of Medicine , Lebanon , NH , USA ;
2
b Department of Epidemiology, Dartmouth Geisel School of Medicine , Lebanon , NH , USA ;
3
c Section of Urology, Department of Surgery, Dartmouth Hitchcock Medical Center , Lebanon , NH , USA ;
4
d Department of Medicine, Dartmouth Geisel School of Medicine , Lebanon , NH , USA ;
5
e Department of Biomedical Data Science, Dartmouth Geisel School of Medicine , Lebanon , NH , USA ;
6
f Department of Surgery , Dartmouth-Hitchcock Medical Center , Lebanon , NH , USA ;
7
g Department of Community and Family Medicine, Dartmouth Geisel School of Medicine , Lebanon , NH , USA.

Abstract

OBJECTIVES:

Soluble suppression of tumorgenicity 2 (sST2) biomarker is an emerging predictor of adverse clinical outcomes, but its prognostic value for in-hospital mortality after coronary artery bypass grafting (CABG) is not well understood. This study measured the association between operative sST2 levels and in-hospital mortality after CABG.

METHODS:

A prospective cohort of 1,560 CABG patients were analysed from the Northern New England Cardiovascular Disease Study Group Biomarker Study. The primary outcome was in-hospital mortality after CABG surgery (nā€‰=ā€‰32).

RESULTS:

After risk adjustment, patients in the third tercile of pre-, post- and pre-to-postoperative sST2 values experienced significantly greater odds of in-hospital death compared to patients in the first tercile of sST2 values. The addition of both postoperative and pre-to-postoperative sST2 biomarker significantly improved ability to predict in-hospital mortality status following CABG surgery, compared to using the EuroSCORE II mortality model alone, (c-statistic: 0.83 [95% CI: 0.75, 0.92], p-value 0.0213) and (c-statistic: 0.83 [95% CI: 0.75, 0.92], p-value 0.0215), respectively.

CONCLUSION:

sST2 values are associated with in-hospital mortality after CABG surgery and postoperative and pre-to-post operative sST2 values improve prediction. Our findings suggest that sST2 can be used as a biomarker to identify adult patients at greatest risk of in-hospital death after CABG surgery. Data availability statement: The data that support the findings of this study are available from the Northern New England Cardiovascular Disease Study Group Biomarker Study. Restrictions apply to the availability of these data, which were used under licence for this study. Data are available with permission from of the Northern New England Cardiovascular Disease Study Group and IRB approval.

CLINICAL SIGNIFICANCE:

Preoperative, postoperative, and pre-to-postoperative sST2 values can be used as a biomarker to identify adult patients at greatest risk of in-hospital morality after CABG surgery.

CLINICAL SIGNIFICANCE:

Preoperative, postoperative, and pre-to-postoperative soluble suppression of tumorgenicity 2 (sST2) values can be used as a biomarker to identify adults at greatest risk of in-hospital morality after CABG surgery. Postoperative and per-to-postoperative sST2 in combination with other established clinical risk factors for in-hospital mortality after CABG surgery can improve the ability of the surgical care team to more accurately identify the risks of CABG surgery. This improvement in prediction of early mortality can assist surgical care teams to determine, with the patient and their families, the most appropriate timing of surgery, surgical alternatives, and surgical and operative care approach.

KEYWORDS:

CABG; Cardiovascular surgery; biomarker; in-hospital mortality; prediction; sST2

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