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RESEARCH PRODUCT

0201: Cardiac surgery associated with cardiopulmonary bypass in patients with stable coronary disease: growth differentiation factor-15 (GDF- 15) as a predictive factor of adverse events?

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BackgroundGrowth differentiation factor-15 (GDF-15) has been identified as a strong marker for cardiovascular disease; however, no data are available concerning the role of GDF-15 in the occurrence of organ dysfunction during cardiac surgery associated with cardiopulmonary bypass (CPB).MethodsThirty four patients, programmed to have non-urgent coronary artery bypass grafting (CABG), were included in our study. Arterial blood samples were taken sequentially from anesthesia induction (IND) until 24h after arrival at the cardiovascular intensive care unit (ICU). Plasma levels of GDF-15, follistatin-like 1 (FLST1), myeloperoxidases (MPO), hydroperoxides and plasma antioxidant status (PAS) were measured at each time-point. Markers of cardiac (cardiac-troponin I, cTnI) and renal dysfunction (neutrophil gelatinase-associated lipocalin, NGAL) and other classical biological factors and clinical data were measured.ResultsGDF-15 plasma levels increased gradually during surgery and after, reaching nearly than three time IND levels in the ICU (2,904±282ng/L vs. 1,061±90ng/L, p<0.001). MPO plasma levels increased dramatically just after unclamping (UNCLAMP, 49±11ng/mL vs. 1,116±94ng/mL, p<0.001) while PAS significantly decreased between IND and UNCLAMP (p<0.05), confirming the high oxidative status of this surgical procedure. Compared with IND levels, cTnI and NGAL increased significantly (p<0.001) after surgery. ICU levels of GDF-15 and NGAL were positively associated (p=0.026).ConclusionsDuring cardiac surgery associated with CPB, GDF-15 levels were notably increased and associated with markers of cardiac injury, renal dysfunction (urea, creatinin, GFR, NGAL) and glycaemia.