Cardiac Biomarkers Predict Long-Term Survival After Cardiac Surgery

Abstract Background Cardiac biomarkers soluble ST-2 (sST-2) and N-terminal prohormone B-type natriuretic peptide (NT-proBNP) may be associated with long-term survival after cardiac surgery. We explored the relationship between long-term survival after cardiac surgery and serum biomarker levels. Methods Patients undergoing cardiac surgery from 2004-2007 were enrolled in a prospective biomarker cohort in the Northern New England Cardiovascular Disease Study Group Registry. Preoperative, postoperative, and the change in serum biomarker levels were categorized by quartile. We used Kaplan-Meier survival analysis and Cox regression models adjusted for variables in the STS's ASCERT long-term survival calculator to study the association of biomarker levels with long-term survival. Following Kaplan-Meier analysis, quartiles 2 and 3 were found to have similar survival and were therefore combined into one category. Results In our cohort (n=1,648), median follow-up time was 8.5 years (IQR: 7.6-9.7), during which there were 227 deaths. The 10-year survival rate was 86%. Kaplan-Meier survival analysis demonstrated a significant (p Conclusions Elevated pre- and post-operative levels of sST-2 or NT-proBNP and large changes in these biomarkers' levels are associated with increased risk of worse survival after cardiac surgery. These biomarkers can be used for risk stratification or assessing postsurgical prognosis.