Difference in GFAP Levels in POCD and Non-POCD Patients After on Pump CABG

Abstract

Introduction On-pump, coronary artery bypass grafting (CABG) is the most common cause of postoperative cognitive dysfunction (POCD) after cardiac surgery. Previous studies showed that the incidence of POCD after cardiac surgery was 60%, higher than non-cardiac surgery with 11.7%. Glial fibrillary acid protein (GFAP) is one of the sensitive biomarkers of brain damage. Previous studies have found that elevated GFAP serum is associated with cognitive impairment. This study aims to measure the difference in GFAP levels in POCD and non-POCD patients after CABG on-pump surgery. Methods This study is a retrospective cohort design study. The data were obtained from 56 subjects undergoing elective CABG on the pump surgery enrolled into two groups consisting of 28 POCD as a case group and 28 non-POCD as a control group. In this study, the ELISA method measured the levels of GFAP biomarkers within 24 hours after surgery. After 72 hours, the patient received a MoCA-INA examination to determine cognitive impairment. Data analysis was carried out by SPSS 23.00 software. Results The mean age of patients in both groups was 60 years and was dominated by males (>85%). POCD patients were found to have a significantly longer duration of cardiopulmonary bypass (CPB) and cross-clamp surgery than non-POCD patients (p = 0.002 and p = 0.004). Postoperative GFAP levels in POCD patients were significantly higher than in non-POCD patients (12.95 ± 7.47 vs 3.80 ± 2.77, p < 0.001). There was a significant increase in GFAP levels compared with non-POCD (8.28 ± 7.24 vs −1.5 ± 3.03, p < 0.001). The area under the curve (AUC) value of GFAP against POCD was 0.887, cut-off GFAP 4.750 with a sensitivity of 92.9% and a specificity of 71.4%. Conclusion POCD patients had higher GFAP levels than non-POCD patients. There are differences in GFAP levels in patients with POCD and non-POCD post-CABG surgery.

Electrical impedance tomography provides information of brain injury during total aortic arch replacement through its correlation with relative difference of neurological biomarkers

“…In addition, GFAP is a protein that found in astrocytes and is released into the bloodstream following brain injury, and it has a high specificity and sensitivity of neurological damages 32 . Nurcahyo et al examined GFAP serum levels for patients with and without postoperative cognitive dysfunction (POCD) after on-pump coronary artery bypass grafting 35 . Their study showed that POCD patients had higher GFAP levels than non-POCD patients, which was consistent with our results in ELISA tests of GFAP levels in serum (Tables S7 , S8 ).…”

“…Nurcahyo et al examined GFAP The correlation of TARV HP and relative difference of TAU protein between T2 and T1 for patients with C T1 -S100B > 115 pg/mL. T2-T1 relative difference between after and before surgery, T3-T1 relative difference between 12 h after and before surgery, T4-T1 relative difference between 24 h after and before surgery, T5-T1 relative difference between 48 h after and before surgery, HCA hypothermic circulatory arrest, ΔARV HCA the difference of average resistivity value before and after HCA phase, k HCA the slope of electrical impedance during HCA phase, MRAI abs maximum of the absolute value of resistivity asymmetric index, TARI abs absolute value of time integral of resistivity asymmetric index, TARV HP time integral of electrical impedance for half flow of perfusion; **means p < 0.01. www.nature.com/scientificreports/ serum levels for patients with and without postoperative cognitive dysfunction (POCD) after on-pump coronary artery bypass grafting 35 . Their study showed that POCD patients had higher GFAP levels than non-POCD patients, which was consistent with our results in ELISA tests of GFAP levels in serum (Tables S7, S8).…”