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Increase in serum S100A1-B and S100BB during cardiac surgery arises from extracerebral sources

R E Anderson1, L O Hansson, O Nilsson

  • 1Department of Cardiothoracic Anaesthetics and Intensive Care, Karolinska Hospital, Stockholm, Sweden. russell.anderson@kirugi.ki.se

The Annals of Thoracic Surgery
|June 1, 2001
PubMed

Insights

Elevated serum S100B after heart surgery often comes from extracerebral sources like fat and muscle. Analyzing S100B dimers separately does not identify the origin of S100B in blood.

Area of Science:

  • Biochemistry
  • Cardiovascular Surgery
  • Biomarkers

Background:

  • Elevated serum S100B levels post-coronary artery bypass grafting (CABG) suggest potential extracerebral contamination.
  • S100B is a protein dimer, with S100A1-B and S100BB being the primary forms analyzed in blood.

Purpose of the Study:

  • To investigate the origin of elevated serum S100B levels following CABG.
  • To determine if analyzing S100B dimers (S100A1-B and S100BB) can differentiate between cerebral and extracerebral sources.
  • To quantify S100B levels in various tissues and shed blood during CABG procedures.

Main Methods:

  • Serum, shed blood, marrow, fat, and muscle samples were collected from patients undergoing CABG.
  • Patients were divided into three groups: cardiopulmonary bypass with cardiotomy reservoir suction (group 1), cell-saver device (group 2), and off-pump surgery (group 3).
  • S100B content and dimer ratios were analyzed in all sample types and groups.

Main Results:

  • Serum S100B was significantly higher (sixfold) in group 1 compared to groups 2 and 3.
  • S100B concentrations were substantially higher (10^2 to 10^4 times) in marrow, fat, muscle tissue, and shed blood than in serum.
  • The ratio of S100A1-B to S100BB remained consistent across all groups and sample types.

Conclusions:

  • The analysis of S100A1-B and S100BB dimers does not distinguish between cerebral and extracerebral S100B origins.
  • S100B is present in high concentrations in extracerebral tissues including fat, muscle, and marrow found in mediastinal blood.
  • Cardiopulmonary bypass itself did not appear to increase S100B levels, suggesting extracerebral tissue contamination is the primary driver of elevated serum S100B post-CABG.
Abstract

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