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S100B as a predictor of size and outcome of stroke after cardiac surgery
H Jönsson1, P Johnsson, M Birch-Iensen
1Department of Cardiothoracic Surgery, University of Lund, Sweden. henrik.jonsson@thorax.lu.se
Insights
S100B protein levels measured after cardiac surgery can predict stroke severity and patient survival. Elevated S100B indicates larger brain lesions and higher mortality risk in post-cardiac surgery stroke patients.
Area of Science:
- Neurology
- Cardiology
- Biomarkers
Background:
- Stroke following cardiac surgery presents a significant clinical challenge with severe outcomes.
- Assessing stroke severity and prognosis solely through clinical and radiological methods is often difficult.
- The glial-derived protein S100B is a potential marker for cerebral ischemia, with elevated levels correlating to lesion size and stroke prognosis.
Purpose of the Study:
- To evaluate the validity of S100B as a predictor for brain lesion size.
- To assess S100B's role in predicting medium-term outcomes in patients experiencing stroke after cardiac surgery.
Main Methods:
- Investigated 20 patients with clinical signs of postoperative stroke over 17 months.
- Measured S100B blood concentrations at 5, 15, and 48 hours post-surgery.
- Confirmed stroke diagnosis and estimated lesion size using CT or MRI, with survival follow-up for 24–39 months.
Main Results:
- S100B concentration at 48 hours post-surgery showed a significant correlation with the size of infarcted brain tissue (r = 0.68, p < 0.001).
- Patients with S100B levels >0.5 microg/L had a 2-year mortality of 78%, compared to 18% for those with levels <0.5 microg/L.
Conclusions:
- Increased S100B levels in post-cardiac surgery stroke patients correlate with the extent of brain tissue infarction.
- High S100B levels at 48 hours post-surgery serve as a negative predictor for medium-term survival in this patient group.
Background:
Stroke after cardiac surgery is a clinical problem with often fatal or disabling outcome. To assess severity and probable outcome in affected patients only from clinical and radiological examinations is difficult. The glial-derived protein S100B has been suggested to be a marker of cerebral ischemia, and increased blood concentrations of S100B have been shown to correlate with size of lesion and prognosis after stroke. We studied the validity of S100B as a predictor of size of brain lesion and median term outcome in a consecutive group of patients suffering from stroke after cardiac surgery.
Methods:
During a period of 17 months, 20 patients with clinical signs of postoperative stroke were investigated with S100B measurement, sampled at 5, 15 and 48 hours after surgery. All patients were examined with computed tomography or magnetic resonance imaging to confirm the diagnosis, and the size of cerebral infarction was estimated from the radiological examinations. The patients were followed up for survival 24 to 39 months after surgery.
Results:
S100B concentration in blood 48 hours after surgery correlated with the size of infarcted brain tissue (r = 0.68, p < 0.001). Nine patients had S100B levels exceeding 0.5 microg/L and a 2-year mortality of 78%, whereas the 11 patients with S100B below 0.5 microg/L had a mortality of 18%.
Conclusions:
Increased S100B in patients with a stroke following cardiac surgery correlate with the size of infarcted brain tissue. High S100B levels 48 hours after surgery have a negative predictive value for median term survival.
