Release of Serum S-100.BETA. Protein and Neuron-Specific Enolase after Off-Pump Coronary Artery Bypass Grafting with and without Intracranial and Cervical Artery Stenosis

Abstract

Purpose: The aim of this study was to quantify the amount of brain damage suffered by patients who underwent off-pump coronary artery bypass grafting (OPCAB) in which S-100β protein and neuron-specific enolase were used. Methods: Thirty-four patients undergoing scheduled OPCAB were enrolled in the study. The patients were divided into two groups according to the results of their magnetic resonance angiography (MRA) and cervical ultrasonography: 13 patients had cervical or intracranial arterial stenosis (Group A), and 21 patients did not (Group B). Blood samples were collected from the arterial catheters immediately before surgery, upon arrival to the intensive care unit, and 6 and 24 hours after surgery. Results: In blood samples collected from patients upon arrival to the intensive care unit, the maximum concentration of serum s-100β protein in Group A was significantly higher than that of Group B (p = 0.029). Though patients in Group A tended to have higher maximum neuron-specific enolase (NSE) concentrations, there were no significant differences in NSE concentrations at any point between the two groups. Conclusions: Our findings show a correlation between the stenosis detected by MRA or cervical ultrasonography and brain damage after OPCAB.

S100B protein and neuron-specific enolase as predictors of cognitive dysfunction after coronary artery bypass graft surgery

“…Considering our findings, S100B protein seems to be more useful as a biochemical marker of POCD than NSE. Although controversy remains, several authors were able to demonstrate a relationship between the degree of cognitive dysfunction and S100B protein, 6,9,10,[29][30][31][32][33] which is consistent with our present findings. Considering that S100B protein is highly brain specific, 28 S100B protein may be a better predictive marker of POCD.…”

“…concentration occurring 30 min postoperatively and returning to basal levels within 18 h after surgery. 29 Although previous studies indicated NSE as a reliable biochemical marker of postoperative dysfunction, 5,9,10 our study failed to demonstrate a solid association between serum NSE and POCD, since only a weak association between NSE levels immediately after surgery and TICS scores in the seventh and 180th postoperative day and a small interaction between time and POCD regarding NSE serum levels were found. Nevertheless, S100B protein serum levels were significantly increased postoperatively in patients displaying POCD as compared with patients without cognitive dysfunction 21 and 180 days after surgery.…”

“…4,5 S100B protein and neuron-specific enolase (NSE) are well known as potential markers of neural injury. [5][6][7][8][9][10][28][29][30][31][32][33][34][35][36] S100B protein is an acidic calciumbinding protein, which is found in astrocytes and Schwann cells, and physiological serum levels of S100B protein are low. In the early stages of brain injury, glial cells are activated, and S100B is released into the blood after neural damage.…”

“…6,7 Both S100B protein and NSE serum levels have been shown to increase following cardiac surgery. [5][6][7][8][9][10] The elevation of serum levels of S100B protein and NSE may help to identify POCD.…”

Perioperative inflammatory response and protein S‐100β concentrations – relationship with post‐operative cognitive dysfunction in elderly patients

“…The serum levels of IL‐1β, IL‐6, TNF‐α, CRP, and S‐100β protein were measured using enzyme‐linked immunosorbent assay (Biosource, Camarillo, CA, USA), following the manufactures instructions. Previous study suggested that the release of serum S‐100β protein after coronary artery surgery reaches the peak at 1 h post‐operation and gradually decreased until the normal level at 24 h post‐operation . Thus, in the current study, no time points later than 6 h after surgery were considered.…”