Preoperative soluble VCAM-1 contributes to predict late mortality after coronary artery surgery

Area of Science:

• Cardiovascular Medicine
• Biomarkers
• Surgical Outcomes

Background:

• Soluble vascular cell adhesion molecule-1 (sVCAM-1) is linked to cardiovascular mortality and new-onset atrial fibrillation.
• Its role in predicting long-term outcomes after coronary artery bypass surgery (CABS) requires further investigation.

Purpose of the Study:

• To evaluate the predictive value of preoperative sVCAM-1 for all-cause and cardiovascular death in patients undergoing elective CABS.
• To compare the prognostic significance of sVCAM-1 with inflammatory markers, CHA2DS2-VASc score, and postoperative atrial fibrillation (POAF).

Main Methods:

• A cohort of 312 patients undergoing elective CABS were prospectively followed for a median of 6.7 years.
• Preoperative sVCAM-1 levels, inflammatory markers, CHA2DS2-VASc score, and POAF incidence were assessed.
• Univariable and multivariable Cox regression analyses were used to determine associations with mortality.

Main Results:

• During 2112 person-years, 41 deaths (10 cardiovascular) occurred.
• Elevated preoperative sVCAM-1, POAF, and CHA2DS2-VASc score were associated with all-cause mortality.
• Multivariate analysis identified preoperative sVCAM-1 and POAF as independent predictors of all-cause death, and sVCAM-1, POAF, and CHA2DS2-VASc score for cardiovascular mortality.

Conclusions:

• Increased preoperative sVCAM-1 levels are a significant independent predictor of long-term all-cause and cardiovascular mortality after CABS.
• sVCAM-1, in conjunction with POAF and CHA2DS2-VASc score, provides valuable prognostic information for patients undergoing CABS.