Preoperative Serum GDF-15, Endothelin-1 Levels, and Intraoperative Factors As Short-Term Operative Risks for Patients Undergoing Cardiovascular Surgery

Overview

Journal J Clin Med

Specialty General Medicine

Date 2021 Jun 2

PMID 34063283

Authors

Takashi Kato

Toshiaki Nakajima

Taira Fukuda

Ikuko Shibasaki

Takaaki Hasegawa

Koji Ogata

Hironaga Ogawa

Shotaro Hirota

Hirotaka Ohashi

Shunsuke Saito

Yusuke Takei

Masahiro Tezuka

Masahiro Seki

Toshiyuki Kuwata

Masashi Sakuma

Shichiro Abe

Shigeru Toyoda

Teruo Inoue

Hirotsugu Fukuda

Affiliations

Soon will be listed here.

Abstract

Objectives: The Society of Thoracic Surgeons (STS) risk score is widely used for the risk assessment of cardiac surgery. Serum biomarkers such as growth differentiation factor-15 (GDF-15) and endothelin-1 (ET-1) are also used to evaluate risk. We investigated the relationships between preoperative serum GDF-15, ET-1 levels, and intraoperative factors and short-term operative risks including acute kidney injury (AKI) for patients undergoing cardiovascular surgery.

Methods: In total, 145 patients were included in this study (92 males and 53 females, age 68.4 ± 13.2 years). The preoperative STS score was determined, and the serum GDF-15 and ET-1 levels were measured by ELISA. These were related to postoperative risks, including AKI, defined according to the Acute Kidney Injury Network (AKIN) classification criteria.

Results: AKI developed in 23% of patients. The GDF-15 and ET-1 levels correlated with the STS score. The STS score and GDF-15 and ET-1 levels all correlated with preoperative eGFR, Alb, Hb, and BNP levels; perioperative data (urine output); ICU stay period; and postoperative admission days. Patients with AKI had longer circulatory pulmonary bypass (CPB) time, and male patients with AKI had higher ET-1 levels than those without AKI. In multivariable logistic regression analysis, the preoperative ET-1 level and CPB time were the independent determinants of AKI, even adjusted by age, sex, and BMI. The preoperative GDF-15 level, CPB time, and RCC transfusion were independent determinants of 30-day mortality plus morbidity.

Conclusion: Preoperative GDF-15 and ET-1 levels as well as intraoperative factors such as CPB time may be helpful to identify short-term operative risks for patients undergoing cardiovascular surgery.

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