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S100B protein and neuron-specific enolase as predictors of cognitive dysfunction after coronary artery bypass graft
Fernando P Silva1, Andre P Schmidt, Livia S Valentin
1From the Department of Anaesthesia and Surgical Intensive Care, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo (FPS, LSSV, KOP, SPZ, DAO, JOCA, MJCC); Department of Anaesthesia and Perioperative Medicine, Division of Anaesthesia, Hospital de Clinicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul (UFRGS) (APS); Department of Surgery, Federal University of Health Sciences of Porto Alegre (UFCSPA) (APS); Department of Biochemistry, Institute of Health Sciences (ICBS), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre (APS, LVP, DOS); Laboratório de Neurociências Clinicas, Programa de Pós-graduação em Saúde e Comportamento, Centro de Ciências da Vida e da Saúde e Hospital Universitário São Francisco de Paula, Universidade Católica de Pelotas, Pelotas (JPO, CDW); and Brain Institute, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil (ABLT).
Background:
Postoperative cognitive dysfunction (POCD) may be related to the systemic inflammatory response and an increase in serum markers of brain injury such as S100B protein and neuron-specific enolase (NSE).
Objective:
The study aims to evaluate the association between POCD and serum levels of S100B and NSE after coronary artery bypass grafting surgery (CABG).
Design:
Prospective observational study.
Setting:
Single university teaching hospital.
Patients:
We investigated 88 patients undergoing CABG.
Main Outcomes Measures:
Cognitive function was measured preoperatively, and at the 21st and 180th postoperative days (i.e. 6 months after surgery). S100B protein and NSE serum levels were evaluated preoperatively, after induction of anaesthesia, at the end of surgery and at 6 and 24 h after surgery.
Results:
The incidence of POCD was 26.1% at 21 days after surgery and 22.7% at 6 months after surgery. Increased serum levels of S100B protein and NSE were observed postoperatively and may indicate brain damage.
Conclusion:
Although serum levels of S100B protein and NSE are both significantly increased postoperatively, our findings indicate that serum levels of S100B protein may be more accurate than NSE in the detection of POCD after CABG.
Trial Registration:
NCT01550159.
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