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ORIGINAL ARTICLES  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2003 February;44(1):31-5

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Elevated levels of s-100β correlate with neurocognitive outcome after cardiac surgery

Farsak B., Gunaydin S., Yorgancioglu C., Zorlutuna Y.

Department of Thoracic and Cardiovascular Surgery Bayindir Hospital, Ankara, Turkey


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Aim. S-100β is a spe­cific astro­glial pro­tein ­whose ­serum ­level ­increases ­after cere­bral ­injury. The pur­pose of ­this ­study was to inves­ti­gate the cor­re­la­tion ­between ele­vated ­levels of S-100β and the neu­ro­cog­ni­tive out­come ­after car­diac sur­gery.
­Methods. ­Fifty con­sec­u­tive ­patients under­going elec­tive cor­o­nary ­artery ­bypass ­grafting ­were ­studied. ­Serum S-100β ­levels ­were meas­ured on induc­tion of ­anaesthesia, at the 15th ­minute, at ­skin clo­sure and on the ­1st post­op­er­a­tive day. Neu­ro­cog­ni­tive out­come was eval­u­ated by ­STAI-T and ­Zung ­tests pre­op­er­a­tively and by ­Mini-­mental ­state exam­ina­tion ­every post­op­er­a­tive day ­until dis­charge. Neu­ro­cog­ni­tive ­tests and S-100β ­levels ­were cor­re­lated ­within the ­scope of ­risk fac­tors by ­Pearson cor­re­la­tion.
­Results. ­Serum S-100β was not ­detected pre­op­er­a­tively. ­Peak ­serum S-100β ­levels ­were ­reached at ­skin clo­sure in 36 of 50 ­patients (72%). In 24 ­hours, ­serum S-100β dis­ap­peared in 25 ­patients but was ­still ele­vated in 11 (22%). A ­highly sig­nif­i­cant cor­re­la­tion was dem­on­strated ­between the dura­tion of CPB and ­peak ­serum S-100β ­levels (r=0.91). ­There was a ­weak cor­re­la­tion ­between age and ­peak S-100β ­levels (r=0.62). ­Nine ­patients (18%) had a pos­i­tive ­MMSE ­test ­which cor­re­lated ­well ­with per­sis­tent ­high ­serum S-100 ­levels (r=0.98).
Con­clu­sion. ­Serum S-100β is a prom­ising ­early bio­chem­ical ­marker for cere­bral ­injury fol­lowing car­diac sur­gery ­within a ­good cor­re­la­tion ­with the CPB ­time, age and espe­cially ­with neu­ro­cog­ni­tive ­tests.

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