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Preoperative Serum GDF-15, Endothelin-1 Levels, and Intraoperative Factors as Short-Term Operative Risks for Patients

Takashi Kato1, Toshiaki Nakajima2,3, Taira Fukuda4

  • 1Department of Cardiovascular Surgery, Dokkyo Medical University, Tochigi 321-0293, Japan.

Journal of Clinical Medicine
|June 2, 2021
PubMed
Summary

Preoperative growth differentiation factor-15 (GDF-15) and endothelin-1 (ET-1) levels, along with cardiopulmonary bypass time, can help predict short-term operative risks like acute kidney injury in cardiovascular surgery patients.

Keywords:
ET-1GDF-15STS risk scoreacute kidney injurycardiopulmonary bypass timecardiovascular surgeryendothelin-1growth differentiation factor-15morbiditymortalityoperative risk

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Area of Science:

  • Cardiovascular Surgery
  • Nephrology
  • Biomarker Discovery

Background:

  • The Society of Thoracic Surgeons (STS) risk score is a standard for cardiac surgery risk assessment.
  • Serum biomarkers like growth differentiation factor-15 (GDF-15) and endothelin-1 (ET-1) are emerging tools for risk evaluation.
  • Identifying reliable predictors for short-term operative risks, including acute kidney injury (AKI), is crucial for patient outcomes.

Purpose of the Study:

  • To investigate the relationship between preoperative serum GDF-15 and ET-1 levels and intraoperative factors.
  • To assess the association of these biomarkers and factors with short-term operative risks, specifically AKI.
  • To determine the predictive value of GDF-15, ET-1, and intraoperative variables for AKI and 30-day mortality/morbidity.

Main Methods:

  • A cohort of 145 patients undergoing cardiovascular surgery was studied.
  • Preoperative STS scores were recorded, and serum GDF-15 and ET-1 levels were measured using ELISA.
  • Postoperative AKI was assessed using the Acute Kidney Injury Network (AKIN) criteria, and correlations with various clinical and laboratory parameters were analyzed.

Main Results:

  • AKI occurred in 23% of patients.
  • GDF-15 and ET-1 levels correlated with STS scores, eGFR, Alb, Hb, BNP, urine output, ICU stay, and hospital stay.
  • Multivariable analysis identified preoperative ET-1 levels and cardiopulmonary bypass (CPB) time as independent predictors of AKI.
  • Preoperative GDF-15, CPB time, and RCC transfusion were independent predictors of 30-day mortality plus morbidity.

Conclusions:

  • Preoperative GDF-15 and ET-1 levels are associated with short-term operative risks in cardiovascular surgery.
  • Intraoperative factors, particularly CPB time, are significant determinants of AKI and overall adverse outcomes.
  • These biomarkers and intraoperative data may enhance risk stratification for patients undergoing cardiovascular procedures.