• Aaron Wozolek, Oceane Jaquet, Anne-Françoise Donneau, Patrizzio Lancellotti, Caroline Legoff, Etienne Cavalier, Marc A Radermecker, Jean-Paul Lavigne, Rodolphe Durieux, Laurence Roediger, Marc Senard, Marie Bernard Hubert, Jean-François Brichant, Philippe Amabili, and Grégory A Hans.
• Department of Anesthesia and Intensive Care Medicine, CHU of Liège, Liège, Belgium.
• J. Cardiothorac. Vasc. Anesth. 2022 Mar 1; 36 (3): 862-869.

ObjectivesCirculating cardiac biomarkers may improve the prediction of long-term outcomes after cardiac surgery. The authors sought to assess if cardiac biomarkers also help better predict short-term morbidity.DesignProspective observational study.SettingSingle academic hospital.ParticipantsA total of 250 patients undergoing aortic or mitral valve surgery with or without associated coronary artery bypass grafts.InterventionNone MEASUREMENT AND MAIN RESULTS: Relationships between preoperative plasma concentrations of four cardiac biomarkers (sST2, Galectin-3, GDF-15, and NT-proBNP) and postoperative outcome were assessed using logistic regressions and Cox proportional hazards models. The primary outcome was a composite of 30-day mortality, an inotropic support longer than 48 hours and an initial length of stay in the intensive care >five days. Secondary outcome measures were postoperative acute kidney injury, inotropic support duration, lengths of intensive care unit and hospital stays, and 30-day and one-year mortality. No association was observed between any of the four cardiac biomarkers and the primary outcome. The preoperative levels of Galectin-3 (hazard ratio = 1.2; p < 0.001) and sST2 (hazard ratio = 1.01, p < 0.001) were significantly associated with one-year survival, and their addition to the EuroSCORE II significantly improved the prediction of one-year mortality (p < 0.001). Similarly, Galectin-3 was associated with postoperative acute kidney injury (odds ratio = 1.15, p = 0.001) and improved the prediction of this complication when added to the EuroSCORE II (p = 0.002).ConclusionsThese results suggested that the ability of cardiac biomarkers to predict short-term outcome after cardiac surgery, though of interest, appears limited. Conversely, cardiac biomarkers may have the potential to refine the prediction of long-term outcome. Admittedly, all positive results were obtained on secondary outcomes and must be regarded with caution.Copyright © 2021 Elsevier Inc. All rights reserved.

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