Prediction of Japan Score and Society of Thoracic Surgeons Risk Scores for Patients Undergoing Cardiovascular Surgery by Serum Growth Differentiation Factor-15 and Endothelin-1 Levels.

BACKGROUND

The Society of Thoracic Surgeons surgical risk score (STS Score) is widely used to assess risk in cardiac surgery along with the Japan Score (Japan surgical risk score) in conjunction with the various biomarkers.

METHODS

Preoperative blood tests were performed on 127 patients who subsequently underwent cardiovascular surgery (78 men, 49 women; mean age, 69.5 years). Serum levels of growth differentiation factor (GDF)-15, endothelin-1, and adiponectin were measured by enzyme-linked immunosorbent assay and used as independent variables in multivariate regression analysis with the STS Score or Japan Score as the dependent variable.

RESULTS

Serum levels of GDF-15, endothelin-1, and adiponectin correlated positively with the STS Score, the Japan Score, and the plasma brain natriuretic peptide (BNP) level, and correlated negatively with the estimated glomerular filtration rate (eGFR) and hemoglobin and albumin levels. After adjustment for age, sex, and body mass index, multivariate linear regression analysis showed that log (GDF-15) defined log (STS Score), and log (GDF-15) and log (endothelin-1) were independent factors defining log (Japan Score) (GDF-15: β = 0.372, p < 0.001; endothelin-1: β = 0.213, p = 0.016). eGFR and levels of hemoglobin and albumin defined log (GDF-15), and log (BNP) defined log (endothelin-1).

CONCLUSIONS

The STS Score and the Japan Score were associated with serum GDF-15 level in patients undergoing cardiovascular surgery. It is likely that the Japan Score had a stronger association with heart failure than the STS Score.