S100beta correlates with neurologic complications after aortic operation using circulatory arrest

Area of Science:

• Neurosurgery
• Cardiovascular Surgery
• Biomarker Research

Background:

• Astrocyte protein S100beta is a potential serum marker for neurologic injury.
• Hypothermic circulatory arrest (HCA) is used during thoracic aortic repair.
• The role of S100beta in HCA and the impact of retrograde cerebral perfusion (RCP) are not fully understood.

Purpose of the Study:

• To determine if elevated serum S100beta correlates with neurologic complications after HCA during thoracic aortic repair.
• To assess the impact of RCP on S100beta release in this patient population.

Main Methods:

• Thirty-nine patients undergoing thoracic aortic repair with HCA were studied.
• RCP was utilized in 25 of these patients.
• Serum S100beta levels were measured preoperatively, post-cardiopulmonary bypass, and 24 hours postoperatively.

Main Results:

• Neurologic complications occurred in 8% of patients.
• Higher post-bypass S100beta levels were associated with neurologic complications (p=0.013).
• S100beta levels ≥ 6.0 microg/L correlated with a significantly higher incidence of neurologic complications (43% vs 0%, p=0.005).
• RCP did not influence S100beta release.

Conclusions:

• Serum S100beta levels ≥ 6.0 microg/L after HCA are predictive of postoperative neurologic complications.
• RCP does not appear to offer improved cerebral protection compared to HCA alone, based on S100beta as a brain injury marker.