Related Experiment Video
Updated: Sep 27, 2026
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Increased S100B in blood after cardiac surgery is a powerful predictor of late mortality
Per Johnsson1, Martin Bäckström, Cecilia Bergh
1Department of Coronary Artery Disease, Center of Heart and Lung Disease, Institute of Laboratory Medicine, Lund University Hospital, Lund, Sweden. pelle.johnsson@skane.se
Insights
Elevated S100B levels after cardiac surgery predict higher long-term mortality. This brain injury marker is the strongest predictor of death, especially with central nervous system complications.
Area of Science:
- Cardiology
- Neurology
- Biochemistry
Background:
- Long-term outcomes post-cardiac surgery, particularly stroke-related mortality, are understudied.
- S100B protein serves as a biomarker for brain cell damage and blood-brain barrier disruption.
- Previous reports suggest increased long-term mortality in cardiac surgery patients experiencing stroke.
Purpose of the Study:
- To assess long-term mortality in patients undergoing cardiac operations.
- To determine if elevated S100B blood concentrations predict mortality risk.
- To identify predictors of mortality following cardiac surgery.
Main Methods:
- Prospective collection of clinical data and S100B levels in 767 patients surviving >30 days post-operation.
- Actuarial survival analysis was performed on all patients.
- Cox multiple regression analysis was used for 678 patients to identify independent predictors of mortality.
Main Results:
- 49 patients (6.4%) died within 18-42 months follow-up.
- Elevated S100B levels (>0.3 microg/L) were found in 11.5% of patients 2 days post-operation.
- S100B levels significantly predicted mortality, with a 23.9% death probability for elevated levels vs. 4.1% for normal levels. Other predictors included renal failure, low ejection fraction, emergency surgery, and CNS complications.
Conclusions:
- Slightly elevated S100B levels post-cardiac operation indicate a poor prognosis.
- The predictive value of S100B is amplified when central nervous system complications are present.
- S100B is the most potent predictor of long-term mortality after cardiac surgery.
Background:
Long-term outcome in patients who suffered stroke after undergoing a cardiac operation has been investigated sparingly, but increased long-term mortality has been reported. S100B is a biochemical marker of brain cell ischemia and blood-brain barrier dysfunction. The aim of this investigation was to record the long-term mortality in consecutive patients undergoing cardiac operations and to explore whether increased concentrations of S100B in blood had a predictive value for mortality.
Methods:
Prospectively collected clinical variables, including S100B, in 767 patients who survived more than 30 days after a cardiac operation, were analyzed with actuarial survival analysis and 678 patients were analyzed with Cox multiple regression analysis.
Results:
Forty-nine patients (6.4%) were dead at follow-up (range, 18 to 42 months); 11.5% (88 of 767 patients) had elevated S100B 2 days after operation (range, 38 to 42 hours). The probability for death at follow-up was 0.239 if the S100B level was more than 0.3 microg/L, and 0.041 if it was less than 0.3 microg/L. The clinical variables independently associated with mortality were preoperative renal failure, preoperative low left ventricular ejection fraction, emergency operation, severe postoperative central nervous system complication, and elevated S100B values, which turned out to be the most powerful predictor.
Conclusions:
Even slightly elevated S100B values in blood 2 days after cardiac operation imply a bad prognosis for outcome, and especially so in combination with any central nervous system complication.
Related Concept Videos
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:30Acute Coronary Syndrome III: Diagnostic Studies