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The Association Between Novel Biomarkers and 1-Year Readmission or Mortality After Cardiac Surgery.
- Source :
-
The Annals of thoracic surgery [Ann Thorac Surg] 2018 Oct; Vol. 106 (4), pp. 1122-1128. Date of Electronic Publication: 2018 Jun 01. - Publication Year :
- 2018
-
Abstract
- Background: Novel cardiac biomarkers including soluble suppression of tumorigenicity 2, galectin-3, and the N-terminal prohormone of brain natriuretic peptide may be associated with long-term adverse outcomes after cardiac surgery. We sought to measure the association between cardiac biomarker levels and 1-year hospital readmission or mortality.<br />Methods: Plasma biomarkers from 1,047 patients discharged alive after isolated coronary artery bypass graft surgery from 8 medical centers were measured in a cohort from the Northern New England Cardiovascular Disease Study Group between 2004 and 2007. We evaluated the association between preoperative and postoperative biomarkers and 1-year readmission or mortality using Kaplan-Meier estimates and Cox proportional hazards modeling, adjusting for covariates used in The Society of Thoracic Surgeons 30-day readmission model.<br />Results: The median follow-up time was 365 days. After adjustment for established risk factors, above-median levels of postoperative galectin-3 (median 10.35 ng/mL; hazard ratio, 1.40; 95% confidence interval, 1.08 to 1.80; p = 0.010) and N-terminal prohormone of brain natriuretic peptide (median = 15.21 ng/mL, hazard ratio, 1.42; 95% confidence interval, 1.07 to 1.87; p = 0.014) were each significantly associated with 1-year readmission or mortality.<br />Conclusions: In patients undergoing cardiac surgery, novel cardiac biomarkers were associated with readmission or mortality independent of established risk factors. Measurement of these biomarkers may improve our ability to identify patients at highest risk for readmission or mortality before discharge. This will also allow resource allocation accordingly, while implementing strategies for personalized medicine based on the biomarker profile of the patient.<br /> (Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Biomarkers blood
Cause of Death
Cohort Studies
Coronary Artery Bypass methods
Coronary Disease mortality
Coronary Disease surgery
Female
Hospital Mortality
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
New England
Prognosis
Proportional Hazards Models
Prospective Studies
Risk Assessment
Sulfotransferases
Survival Analysis
Time Factors
Coronary Artery Bypass mortality
Coronary Disease blood
Natriuretic Peptide, Brain blood
Patient Readmission statistics & numerical data
Registries
Sulfurtransferases blood
Subjects
Details
- Language :
- English
- ISSN :
- 1552-6259
- Volume :
- 106
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Annals of thoracic surgery
- Publication Type :
- Academic Journal
- Accession number :
- 29864407
- Full Text :
- https://doi.org/10.1016/j.athoracsur.2018.04.084