Macrophage Migration Inhibitory Factor Predicts Outcome in Complex Aortic Surgery

Area of Science:

• Cardiovascular Surgery
• Inflammation and Immunology
• Biomarker Discovery

Background:

• The perioperative inflammatory response significantly impacts outcomes following complex aortic repair.
• Macrophage migration inhibitory factor (MIF) has dual roles, showing protective effects in ischemia-reperfusion but also pro-inflammatory effects in acute inflammation.

Purpose of the Study:

• To investigate the role of MIF in the perioperative inflammatory response after complex aortic repair.
• To assess the diagnostic ability of MIF levels for predicting patient survival and discharge modality.

Main Methods:

• Prospective study of 52 patients undergoing open repair (OR) or endovascular repair (ER) between 2014-2015.
• Measurement of serum MIF levels up to 72 hours post-operatively.
• Analysis using linear mixed models and Receiver Operating Characteristic (ROC) analysis.

Main Results:

• Open repair (OR) induced higher perioperative MIF release compared to endovascular repair (ER).
• MIF levels at 24 hours post-ICU admission demonstrated good diagnostic value for patient survival (AUC, 0.688) and discharge modality (AUC, 0.789).
• MIF course was significantly influenced by baseline MIF levels and APACHE II scores.

Conclusions:

• Increased perioperative MIF levels correlate with an elevated risk of adverse outcomes in complex aortic surgery.
• MIF may serve as a valuable biomarker for risk stratification in patients undergoing complex aortic procedures.