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

Journal of Clinical Medicine

Shichiro Abe¹  Shigeru Toyoda¹  Masashi Sakuma¹  Toshiaki Nakajima¹  Teruo Inoue¹  Masahiro Seki²  Hirotaka Ohashi²  Koji Ogata²  Hironaga Ogawa²  Takashi Kato²  Ikuko Shibasaki²  Toshiyuki Kuwata²  Yusuke Takei²  Shunsuke Saito²  Hirotsugu Fukuda²  Shotaro Hirota²  Masahiro Tezuka²  Taira Fukuda³  Takaaki Hasegawa⁴ 

[1]Department of Cardiovascular Medicine, Dokkyo Medical University, Tochigi 321-0293, Japan

[2]Department of Cardiovascular Surgery, Dokkyo Medical University, Tochigi 321-0293, Japan

[3]Department of Liberal Arts and Human Development, Kanagawa University of Human Services, Kanagawa 238-8522, Japan

[4]Department of Medical KAATSU Training, Dokkyo Medical University, Tochigi 321-0293, Japan

关键词: growth differentiation factor-15;    GDF-15;    endothelin-1;    ET-1;    cardiovascular surgery;    STS risk score;   

DOI  :  10.3390/jcm10091960

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown