Circulating histones for predicting prognosis after cardiac surgery: a prospective study

Area of Science:

• Cardiovascular Surgery
• Biomarker Discovery
• Critical Care Medicine

Background:

• Cardiac surgery with cardiopulmonary bypass (CPB) can lead to significant physiological stress.
• Monitoring perioperative biomarkers is crucial for assessing patient outcomes after CPB.
• Histones are emerging as potential indicators of cellular damage and inflammation.

Purpose of the Study:

• To evaluate perioperative changes in circulating histones following cardiac surgery with CPB.
• To investigate the relationship between circulating histones and other biomarkers (NT-proBNP, PCT, CRP).
• To determine the association of circulating histones with clinical outcomes in these patients.

Main Methods:

• Prospective study of 48 patients undergoing cardiac surgery with CPB.
• Measurement of circulating histones, NT-proBNP, PCT, and CRP at multiple perioperative time points.
• Correlation analysis between biomarker levels and clinical outcomes like ventilation and ICU time.

Main Results:

• Circulating histones, NT-proBNP, PCT, and CRP levels significantly increased postoperatively.
• Histone levels peaked earliest (at 0 h post-op) compared to other biomarkers.
• Higher peak histone levels were associated with adverse events and correlated significantly with other biomarkers and clinical parameters.

Conclusions:

• Circulating histones rise rapidly after cardiac surgery with CPB, preceding other common biomarkers.
• Peak histone levels demonstrate strong predictive value for adverse postoperative events.
• Histones show significant correlations with established biomarkers and clinical outcomes, positioning them as a potential prognostic indicator.