Related Experiment Videos
Significance of serum S100 release after coronary artery bypass grafting
H Jönsson1, P Johnsson, C Alling
1Department of Heart-Lung Diseases, University Hospital MAS, Malmö, Sweden.
Insights
S100 protein levels after cardiac surgery indicate cerebral complications. Early S100 release is linked to surgery factors, while later release (5-48 hours) correlates with neurological issues like stroke.
Area of Science:
- Biochemistry
- Neurology
- Cardiovascular Surgery
Background:
- S100 protein is a potential serum marker for neurological complications following cardiac surgery with extracorporeal circulation.
- Characterizing S100 protein release patterns is crucial for understanding post-operative cerebral issues.
Purpose of the Study:
- To investigate the S100 protein release pattern in patients undergoing coronary artery bypass grafting (CABG) with extracorporeal circulation.
- To determine the association between S100 protein levels and cerebral complications after CABG.
Main Methods:
- Prospective registration of clinical variables and outcomes in 515 consecutive CABG patients.
- Clinical examination to assess cerebral outcomes.
- Measurement of S100 protein levels at the end of extracorporeal circulation and at 5, 15, and 48 hours post-operation.
Main Results:
- Early S100 release (immediately after extracorporeal circulation) correlated with patient age and perfusion time, but not with cerebral outcome.
- Delayed S100 release (5-48 hours post-operation) was associated with cerebral complications, including stroke, delayed awakening, and encephalopathy.
- Patients with stroke exhibited higher S100 levels at 15-48 hours post-operation. Renal failure patients showed higher S100 levels at 5 hours.
Conclusions:
- Distinct S100 protein release patterns (early vs. late) suggest different underlying release mechanisms.
- Late S100 protein release (5-48 hours) shows significant potential as a biochemical marker for detecting cerebral damage after extracorporeal circulation.
Background:
S100 protein has been suggested to be a serum marker for cerebral complications after cardiac operation and extracorporeal circulation. The aim of this study was to characterize the S100 release pattern after extracorporeal circulation in 515 consecutive patients undergoing coronary artery bypass grafting.
Methods:
Clinical variables and outcome were prospectively registered. The cerebral outcome was determined by clinical examination. S100 was measured at the end of extracorporeal circulation, and after 5, 15, and 48 hours.
Results:
After operation, 13 patients had stroke, 12 had delayed awakening, and 17 had encephalopathy. Early S100 release, immediately after extracorporeal circulation, was associated with age and perfusion time, but not with cerebral outcome. However, S100 release after 5 to 48 hours was associated with cerebral complications and risk factors for such outcome. Patients with stroke had higher S100 levels after 15 to 48 hours. A subset of patients with renal failure had overall higher S100 levels at 5 hours.
Conclusions:
Early and late S100 release indicate different mechanisms for release and emphasizes the potential power of this new biochemical marker for cerebral damage.