S-100 Protein and Neuron-Specific Enolase as Markers of Subclinical Cerebral Damage after Cardiac Surgery: Preliminary Observation of a 6-Month Follow-Up Study

Abstract Background Following catheter ablation for atrial fibrillation (AF), CHADS2 and CHA2DS2-VASc have utility in predicting long-term outcomes. However, it is currently unknown if the same holds for patients undergoing surgical ablation. Purpose To determine whether CHADS2 and CHA2DS2-VASc predict long-term outcomes after surgical ablation in concomitance with other cardiac surgery. Methods In this prospective, follow-up study, we included patients who underwent biatrial ablation - or pulmonary vein isolation procedure concomitantly with other cardiac surgery between 2004 and 2018. CHADS2 and CHA2DS2-VASc scores were assessed prior to surgery and categorized in groups as 0–1, 2–4 or ≥5. Outcomes were death, AF, and AF-related death. Follow-up was ended in April 2019. Results A total of 587 patients with a mean age of 68.7±0.4 years were included. Both CHADS2 and CHA2DS2-VASc scores were predictors of survival p=0.005 and p<0.001, respectively (Figure). For CHADS2, mean survival times were 5.9±3.7 years for scores 0–1, 5.0±3.0 years for scores 2–4 and 4.3±2.6 years for scores ≥5. For CHA2DS2-VASc mean survival times were 7.3±4.0 years for scores 0–1, 5.6±2.9 years for scores 2–4 and 4.8±2.1 years for scores ≥5. The incidence of death was 20.1% for CHADS2 0–1, 24.8% for CHADS2 2–4, and 35.3% for CHADS2 ≥5, p=0.186. The incidence of AF was 50.2% for CHADS2 0–1, 47.9% for CHADS2 2–4, and 76.5% for CHADS2 ≥5, p=0.073. The incidence of AF related death was 13.0% for CHADS2 0–1, 16.8% for CHADS2 2–4, and 35.3% for CHADS2 ≥5, p=0.031. The incidence of death was 16.8% for CHA2DS2-VASc 0–1, 26.2% for CHA2DS2-VASc 2–4, and 45.0% for CHA2DS2-VASc ≥5, p=0.001. The incidence of AF was 49.6% for CHA2DS2-VASc 0–1, 52.5% for CHA2DS2-VASc 2–4, and 72.5% for CHA2DS2-VASc ≥5, p=0.035. The incidence of AF related death was 12.2% for CHA2DS2-VASc 0–1, 16.0% for CHA2DS2-VASc 2–4, and 42.5% for CHA2DS2-VASc ≥5, p<0.001. Conclusion Both CHADS2 and CHA2DS2-VASc scores predict long-term outcomes after surgical ablation for AF. However, CHA2DS2-VASc was superior in predicting death, AF, and AF-related death. Survival curves Funding Acknowledgement Type of funding source: None

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P01-302 - The effects of cardiac surgery on health - related quality of life, and emotional status outcomes: a follow-up study

European Psychiatry ◽

10.1016/s0924-9338(10)70510-1 ◽

2010 ◽

Vol 25 ◽

pp. 515 ◽

Cited By ~ 2

Author(s):

H.-B. Rothenhäusler ◽

A. Stepan

Keyword(s):

Quality Of Life ◽

Cardiac Surgery ◽

Health Related Quality ◽

Emotional Status ◽

Follow Up Study ◽

Related Quality ◽

Health Related

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Electroencephalogram-Based Prognosis of Cardiac Surgery — A Long-Term Follow-Up Study

Impact of Cardiac Surgery on the Quality of Life ◽

10.1007/978-1-4613-0647-4_19 ◽

1990 ◽

pp. 145-151

Author(s):

Phiroze L. Hansotia ◽

Percy N. Karanjia ◽

Richard D. Sautter ◽

William O. Myers ◽

Jefferson F. Ray ◽

...

Keyword(s):

Cardiac Surgery ◽

Follow Up Study ◽

Long Term Follow Up

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Follow-up study to prove the prognostic value of P-53, S-100-??, ICAM-1 and 5-S-cysteinyldopa in serum of patients with malignant melanoma

Melanoma Research ◽

10.1097/00008390-199706001-00308 ◽

1997 ◽

Vol 7 (Supplement 1) ◽

pp. S88

Author(s):

E Stockfleth ◽

T Meyer ◽

DammY ◽

O Heckmann ◽

A E Christophers ◽

...

Keyword(s):

Malignant Melanoma ◽

Prognostic Value ◽

Follow Up Study ◽

S 100 ◽

P 53

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Role of Brain Biomarkers S-100-Beta and Neuron-Specific Enolase for Detection and Follow-Up of Hepatic Encephalopathy in Cirrhosis before, during and after Treatment with L-Ornithine-L-Aspartate

GE Portuguese Journal of Gastroenterology ◽

10.1159/000507225 ◽

2020 ◽

Vol 27 (6) ◽

pp. 391-403

Author(s):

Hendrik Strebel ◽

Bernhard Haller ◽

Maximilian Sohn ◽

Wolfgang Schepp ◽

Felix Gundling

Keyword(s):

Hepatic Encephalopathy ◽

Neuron Specific Enolase ◽

Biochemical Parameter ◽

Diagnostic Methods ◽

Study Entry ◽

Diagnostic Tools ◽

Low Grade ◽

S 100

Introduction: Hepatic encephalopathy (HE), in the context of liver cirrhosis, seems to result from low-grade cerebral edema of the astrocytes. Serum brain biomarkers S-100-beta und neuron-specific enolase (NSE) are often elevated in brain injury. We hypothesized that neuromarkers S-100-beta and NSE can be used in the diagnosis of HE, compared with standardized diagnostic tools. Material and Methods: A prospective non-randomized intervention study was performed using L-ornithine-L-aspartate (LOLA) for HE treatment. Primary endpoint was the evaluation of neuromarkers S-100-beta and NSE for detection and diagnosis of follow-up of HE. As secondary endpoints, the efficacy of LOLA on the course of HE and the diagnostic role of Portosystemic-Encephalopathy-Syndrome score (PHES) and critical flicker frequency (CFF) were analyzed. For diagnosis of covert (CHE) and overt (OHE) HE, West-Haven criteria (WHC), PHES and CFF were assessed at study entry. LOLA was applied (20 g i.v.) for 6 days. At the end of the study, HE evaluation was repeated. S-100-beta, NSE and ammonia were assessed in each patient before, during and after therapy with LOLA. Results: 30 patients were included. At study entry, CHE was diagnosed in 50% and OHE in 50% of all subjects. A total of 25 participants completed the study. After LOLA therapy, deterioration of HE occurred in <11%, while most patients showed improvement (e.g. improved CFF in 79%). No significant correlation with HE severity (as diagnosed by WHC, PHES and CFF) could be demonstrated for any biochemical parameter. In addition, there were no significant changes in brain biomarkers during the treatment period. Discussion: While CFF as well as PHES showed good correlation with treatment response, S-100-beta and NSE did not significantly correlate with HE severity compared to proven diagnostic methods, and do not seem reliable biochemical markers for the follow-up under therapy.

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Neurone-specific enolase and Sangtec 100 assays during cardiac surgery: part III - does haemolysis affect their accuracy?

Perfusion ◽

10.1177/026765919701200305 ◽

1997 ◽

Vol 12 (3) ◽

pp. 171-177 ◽

Cited By ~ 30

Author(s):

F Gao ◽

D N F Harris ◽

S Sapsed-Byrne ◽

S Sharp

Keyword(s):

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Neuronal Damage ◽

Red Cells ◽

Cerebral Damage ◽

Correction Formula ◽

S 100 ◽

Serial Dilutions

Neurone-specific enolase (NSE) and Sangtec 100 (S-100) are useful for detecting cerebral damage during cardiopulmonary bypass (CPB). However, red cells contain NSE, and the haemolysis frequently caused by CPB could produce a false rise in NSE; S-100 is not found in red cells and should not be affected. We, therefore, compared the effects of haemolysis on NSE and S-100 to see if correction was necessary and possible. From seven patients, serial dilutions of haemolysed red cells were added to plasma (1/64-1/2048), measured for absorption at 540 nm and assayed for NSE and S-100. S-100 concentrations showed no change with haemolysis. Measured NSE increased significantly with haemolysis >1/512 (an increase of 6.6 μg/ml): a correction formula is presented. In 39/48 patients after CPB, mean haemolysis was <1/256 and would not need any correction. NSE and S-100 assay can, therefore, be used throughout CPB, which allows both glial and neuronal damage to be studied.

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