Circulating Biomarkers to Predict Post-Operative Cognitive Decline in Patients Undergoing Coronary Artery Bypass...

Area of Science:

• Neuroscience
• Cardiology
• Biochemistry

Background:

• Post-operative cognitive decline (POCD) is a significant concern following cardiac surgery, particularly Coronary Artery Bypass Grafting (CABG).
• POCD is associated with neuroinflammation and oxidative stress, impacting cognitive functions.
• Identifying reliable biomarkers is crucial for early detection and management.

Purpose of the Study:

• To investigate the dynamic changes in neurotrophic, inflammatory, and oxidative stress markers in post-CABG patients.
• To identify potential biomarkers for predicting POCD.
• To understand the underlying mechanisms of cognitive decline after CABG.

Main Methods:

• Blood samples were collected from post-CABG patients at baseline and 3-month follow-up.
• Expression levels of oxidative stress regulators (NRF2, GST, GSS, HMOX1, CAT, HSP27, LOX-1), inflammatory mediators (IL-6, IP-10, NFκB), and BDNF were analyzed.
• Cognitive function was assessed using RBANS, TMT, TIB, and MMSE.

Main Results:

• POCD patients showed an initial increase in antioxidant genes that failed to sustain, leading to decreased HMOX1, IP-10, and BDNF, and increased LOX-1 and NFκB.
• Non-POCD patients maintained elevated antioxidant and neuroprotective markers, indicating a robust compensatory response.
• ROC analysis identified HMOX1 and BDNF as predictors of POCD, with LOX-1 and IP-10 as follow-up diagnostic markers.

Conclusions:

• POCD is characterized by a failure in sustained neuroprotection and resolution of oxidative stress and inflammation post-CABG.
• HMOX1, BDNF, LOX-1, and IP-10 show potential as biomarkers for POCD risk stratification and diagnosis.
• Further research and biomarker-based screening are needed to improve cognitive outcomes after cardiac surgery.