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Immature Surfactant Protein Type-B Associates With Graft Patency in Patients Undergoing Coronary Artery Bypass

Sonia Eligini1, Erica Gianazza2, Fabrizio Veglia3

  • 1Unit of Functional Proteomics, Metabolomics and Network Analysis, Centro Cardiologico Monzino IRCCS, Milano, Italy.

JACC. Advances
|September 4, 2025
PubMed

Insights

Elevated immature surfactant protein type-B (proSP-B) before coronary artery bypass graft (CABG) surgery predicts long-term graft occlusion. This biomarker improves risk prediction for graft patency after CABG surgery.

Area of Science:

  • Cardiovascular Surgery
  • Biomarker Discovery
  • Medical Diagnostics

Background:

  • Coronary artery bypass graft (CABG) surgery is a key treatment for complex multivessel coronary artery disease.
  • Long-term graft occlusion after CABG remains a significant clinical challenge.
  • Immature surfactant protein type-B (proSP-B) is a potential predictor of adverse cardiovascular events.

Purpose of the Study:

  • To investigate the association between preoperative plasma proSP-B levels and graft occlusion 18 months post-CABG.
  • To determine if elevated proSP-B can predict graft occlusion after CABG.
  • To assess the added predictive value of proSP-B in a multivariable model for long-term graft patency.

Main Methods:

  • Evaluated proSP-B in 40 patients with occluded grafts and 130 without occlusions.
  • Assessed 18-month graft patency using coronary computed tomography angiography and/or invasive angiography.
  • Employed logistic regression and receiver-operating characteristic curves for analysis.

Main Results:

  • Preoperative proSP-B was significantly higher in patients with occluded grafts compared to those without (P = 0.002).
  • ProSP-B independently predicted increased risk of graft occlusion, even after adjusting for clinical factors.
  • Inclusion of proSP-B improved the predictive model's area under the curve from 0.7204 to 0.7733 (P = 0.02).

Conclusions:

  • Elevated preoperative proSP-B is an independent predictor of 18-month graft occlusion following CABG.
  • ProSP-B enhances existing predictive models for graft patency.
  • ProSP-B shows promise as a novel biomarker for risk stratification in patients undergoing surgical revascularization.
Abstract

Keywords:
coronary artery bypass graftgraft occlusionsurfactant protein type B

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