Intraoperative sRAGE kinetics. A new age-related outcome predictor of cardiac surgery

Z Gerontol Geriatr. 2014 Dec;47(8):666-72. doi: 10.1007/s00391-013-0523-7.

Abstract

Background: Glycated proteins (advanced glycation endproducts, AGE) in tissue are associated with degenerative diseases. This study evaluated the role of sRAGE (soluble receptor for advanced glycation endproducts), a decoy receptor of AGEs in blood, for the outcome of patients after coronary artery bypass grafting (CABG).

Methods: A total of 90 patients undergoing CABG were analysed in two centres. Perioperative blood samples were collected before surgery up to 1 week postoperatively. sRAGE was measured by ELISA. Patients were subdivided regarding age (< 64 versus > 70 years, 14 % versus 35 % female), euroSCORE (< 3 versus > 4, 14 % versus 29 % female) and sRAGE changes between sternotomy and end of the operation (< 30 % versus > 45 %, 33 % versus 33 % female) and subsequently analysed with respect of postoperative outcome parameters.

Results: Preoperative sRAGE values did not correlate with the outcome of the patients. sRAGE levels increase within 10 min from 1,539 ± 96 to 5,311 ± 187 pg/ml after sternotomy, then returning to baseline levels within 2 days after surgery. Comparing the analysed possible risk factors age, euroSCORE and sRAGE changes, no difference was observed regarding 30-day mortality. Age and the euroSCORE are superior with respect of tachyarrythmia, whereas sRAGE kinetics seems to be superior with respect of prolonged postoperative respiration time/stay in the intensive care unit or catecholamine support.

Conclusion: A prolonged, increased intraoperative sRAGE level is a new outcome predictor for patients undergoing CABG surgery, mutually complementary to the euroSCORE.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Aged
  • Biomarkers / blood
  • Coronary Artery Bypass / mortality*
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / mortality*
  • Coronary Artery Disease / surgery*
  • Female
  • Germany / epidemiology
  • Humans
  • Male
  • Metabolic Clearance Rate
  • Middle Aged
  • Monitoring, Intraoperative / statistics & numerical data
  • Outcome Assessment, Health Care / methods*
  • Prevalence
  • Prognosis
  • Receptor for Advanced Glycation End Products
  • Receptors, Immunologic / blood*
  • Reproducibility of Results
  • Risk Factors
  • Sensitivity and Specificity
  • Sex Distribution
  • Survival Rate
  • Treatment Outcome

Substances

  • Biomarkers
  • Receptor for Advanced Glycation End Products
  • Receptors, Immunologic