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Serum Periostin as a Novel Biomarker for Predicting 30-Day Major Adverse Cardiac Events After Off-Pump Coronary
Qian Su1, Zhipeng Deng1, Xiangqing Wei1
1Department of Anesthesiology, Affiliated Hospital 2 of Nantong University, Nantong, 226001, People's Republic of China.
Insights
Serum periostin level changes predict major adverse cardiovascular events (MACEs) after off-pump coronary artery bypass grafting (OPCAB). Increased periostin is linked to higher MACE risk, aiding in patient risk stratification.
Area of Science:
- Cardiovascular Surgery
- Biomarkers
- Clinical Prediction
Background:
- Predicting major adverse cardiovascular events (MACEs) is crucial for reducing mortality in off-pump coronary artery bypass grafting (OPCAB).
- Serum periostin levels are explored as a novel predictor for MACEs in OPCAB patients.
Purpose of the Study:
- To evaluate serum periostin levels as a potential predictor of MACEs in patients undergoing OPCAB.
- To establish the relationship between periostin level changes and the incidence of MACEs post-OPCAB.
Main Methods:
- A prospective study of 79 coronary artery disease patients undergoing OPCAB.
- Periostin level changes (ΔPOSTN) were calculated; patients were grouped by optimal ΔPOSTN cut-off.
- MACEs (cardiac death, MI, heart failure, stroke) were monitored for 30 days.
Main Results:
- 13 MACEs (18.3% incidence) occurred within 30 days post-OPCAB.
- Each unit increase in ΔPOSTN correlated with a 4% increased MACE risk (OR: 1.04, p=0.005).
- An optimal ΔPOSTN threshold of 16.6 µg/L demonstrated high sensitivity (76.9%) and specificity (91.4%) for MACE prediction (AUC=0.869).
Conclusions:
- Perioperative changes in serum periostin levels independently predict 30-day MACEs in OPCAB patients.
- Periostin may serve as a valuable biomarker for risk stratification in this patient population.
Background:
The identification of predictors for major adverse cardiovascular events (MACEs) is essential for reducing mortality associated with off-pump coronary artery bypass grafting (OPCAB). The objective of this study is to assess serum periostin levels as a novel predictor of MACEs in patients undergoing OPCAB.
Methods:
This prospective study included 79 patients diagnosed with coronary artery disease (CAD) who underwent OPCAB between May 2022 and May 2023. The changes in periostin levels (ΔPOSTN) were calculated using the formula: postoperative POSTN levels minus preoperative POSTN levels. Based on the optimal cut-off value determined from the receiver operating characteristic (ROC) curve, patients were categorized into Low POSTN Change (LPC) and High POSTN Change (HPC) groups for subgroup analysis. The primary outcomes assessed were MACEs, including cardiac death, myocardial infarction (MI), heart failure, and stroke.
Results:
Follow up for the patients was conducted for 30 days, with 71 patients ultimately being included in the final analysis. During this period, 13 MACEs were recorded, representing an incidence rate of 18.3%. The events included 2 cases of cardiac death (2.8%), 5 cases of MI (7.0%), 5 cases of heart failure (7.0%), and 1 case of stroke (1.4%). The risk of MACEs increased by 4% for each unit increase in the ΔPOSTN (Odds Ratio [OR]: 1.04, 95% Confidence Interval [CI]: 1.01-1.06; p = 0.005). The area under the ROC curve was 0.869 (95% CI: 0.768-0.938; p < 0.001). Based on the Youden index (J = 0.683), the optimal threshold for ΔPOSTN was determined to be 16.6 µg/L, with a sensitivity of 76.9% and a specificity of 91.4%.
Conclusion:
Changes in serum periostin levels during the perioperative period may serve as an independent predictor of 30-day MACEs in patients undergoing OPCAB.
Trial Registration:
Link of the registry: https://www.chictr.org.cn. Date of registration: 2022/05/22. Trial registration number: ChiCTR2200060220.
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