a Dartmouth Geisel School of Medicine, The Dartmouth Institute for Health Policy & Clinical Practice , Lebanon , NH , USA.
b Department of Epidemiology , Dartmouth Geisel School of Medicine , Lebanon , NH , USA.
Biomarkers. 2019 May;24(3):268-276. doi: 10.1080/1354750X.2018.1556338. Epub 2019 Jan 11.
: Soluble suppression of tumorigenicity 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. : A prospective cohort of 1560 CABG patients were analyzed from the Northern New England Cardiovascular Disease Study Group Biomarker Study. The primary outcome was in-hospital mortality after CABG surgery ( = 32). : 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], value 0.0213) and (c-statistic: 0.83 [95% CI: 0.75, 0.92], value 0.0215), respectively. : 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.
可溶性肿瘤抑制因子 2(sST2)生物标志物是一种新兴的不良临床结局预测因子,但它对冠状动脉旁路移植术(CABG)后院内死亡率的预后价值尚不清楚。本研究测量了 CABG 术后手术 sST2 水平与院内死亡率之间的相关性。
从新英格兰北部心血管疾病研究小组生物标志物研究中分析了 1560 例 CABG 患者的前瞻性队列。主要结局是 CABG 手术后院内死亡率(=32)。
在风险调整后,与 sST2 值第一三分位的患者相比,术前、术后和术前至术后 sST2 值处于第三三分位的患者发生院内死亡的几率显著更高。与单独使用 EuroSCORE II 死亡率模型相比,添加术后和术前至术后 sST2 生物标志物显著提高了预测 CABG 手术后院内死亡率的能力,(c 统计量:0.83 [95%CI:0.75,0.92], 值 0.0213)和(c 统计量:0.83 [95%CI:0.75,0.92], 值 0.0215)。
sST2 值与 CABG 手术后院内死亡率相关,术后和术前至术后 sST2 值可改善预测。我们的研究结果表明,sST2 可用作生物标志物来识别 CABG 手术后院内死亡风险最高的成年患者。