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Serum S100 protein: a potential marker for cerebral events during cardiopulmonary bypass
S Westaby1, P Johnsson, A J Parry
1Oxford Heart Centre, England.
Insights
S100 protein levels increase after cardiac surgery with extracorporeal circulation (ECC), indicating potential brain injury. This marker may help assess severity and blood-brain barrier changes during ECC.
Area of Science:
- Neurology
- Cardiology
- Biochemistry
Background:
- Assessing brain injury after cardiac surgery is challenging.
- A reliable serum marker for cerebral injury is needed.
- S100 protein is a potential marker leaking from cerebrospinal fluid to blood after brain injury.
Purpose of the Study:
- To investigate the release pattern of S100 protein after cardiac operations involving extracorporeal circulation (ECC).
Main Methods:
- Serum S100 levels were measured in 34 patients undergoing coronary bypass with ECC and 9 without ECC.
- Measurements were taken before, during, and after surgery.
- Carotid stenosis was noted in 4 patients.
Main Results:
- Postoperative S100 levels correlated significantly with perfusion duration (r = 0.89, p < 0.001).
- Patients without ECC showed minimal S100 elevation, except for one stroke case.
- Patients with carotid stenosis undergoing ECC had higher S100 levels.
Conclusions:
- S100 protein enters the bloodstream during ECC, suggesting cerebral injury and blood-brain barrier permeability.
- S100 shows promise as a marker for cerebral injury in cardiac surgery patients.
- Further research is needed to correlate elevated S100 levels with clinical outcomes.
Background:
There is no simple method to determine the incidence or severity of brain injury after a cardiac operation. A serum marker equivalent to cardiac enzymes is required. S100 protein leaks from the cerebrospinal fluid to blood after cerebral injury. We sought to determine the pattern of release after extracorporeal circulation (ECC).
Methods:
Thirty-four patients without neurologic problems underwent coronary bypass using ECC. Four had carotid stenoses. Nine others underwent coronary bypass without ECC. Serum S100 levels were measured before, during, and after the operation.
Results:
S100 was not detected before sternotomy. Postoperative levels of S100 were related to duration of perfusion (r = 0.89, p < 0.001). Patients who did not have ECC had undetectable or fractionally raised levels except in 1 who suffered a stroke. No patient in whom ECC was used suffered an event, but those with carotid stenosis had greater S100 levels.
Conclusions:
S100 protein leaks into blood during ECC and may reflect both cerebral injury and increased permeability of the blood brain barrier. S100 is a promising marker for cerebral injury in cardiac surgery if elevated levels can be linked with clinical outcome.