Prognostic significance of sICAM-1 and sVCAM-1 molecules for cardiac surgery in pediatric patients with pulmonary hypertension

• Published in: Anadolu kardiyoloji dergisi : AKD Vol. 14; no. 3; p. 274
• Main Authors: Yıldırım, Ayşe, Güzelmeriç, Füsun, Öner, C Naci, Karaağaç, Aysu Türkmen, Şaşmazel, Ahmet, Erdem, Hasan, Özdemir, Osman, Baysal, Ayşe
• Format: Journal Article
• Language: English
• Published: Turkey 01.05.2014
• Subjects: Biomarkers - blood; Cohort Studies; Female; Heart Defects, Congenital - surgery; Humans; Hypertension, Pulmonary - blood; Hypertension, Pulmonary - surgery; Infant; Intercellular Adhesion Molecule-1 - blood; Male; Prognosis; Prospective Studies; ROC Curve; Sensitivity and Specificity; Vascular Cell Adhesion Molecule-1 - blood
• ISSN: 1308-0032
• DOI: 10.5152/akd.2014.4543

To investigate preoperative and postoperative blood levels of soluble intercellular and vascular cell adhesion molecules (sICAM-1, sVCAM-1) in patients with and without pulmonary hypertension (PAH) due to congenital heart disease and left to right (L-R) shunt and to determine whether these molecules can be used as reliable prognostic markers of endothelial activity to predict surgical outcomes. In this observational prospective cohort study; 42 patients, operated for L-R shunt were divided into three groups. Group 1: L-R shunt without PAH, Group 2: L-R shunt with PAH, Group 3: L-R shunt with PAH and postoperative low cardiac output syndrome (LCOS). Their sICAM-1 and sVCAM-1 levels were measured preoperatively (sICAM-0, sVCAM-0) and on the first (sICAM-1, sVCAM-1) and fifth postoperative days (sICAM-2, sVCAM-2).ROC curve for various cut-off levels of sICAM-0, sVCAM-0 in differentiating PAH patients with and without LCOS. In Group 3, sICAM-0 and sVCAM-2 levels were higher than Group 1 and 2. The ROC curve demonstrated a significant association between sICAM-0 in patients with L-R shunt and PAH (Group 2 and 3) and the development of LCOS (area under the curve: 0.98, p<0.01 and 0.97, p<0.01, respectively). At a sICAM-0 concentration >359 ng/mL, there was a sensitivity of 90% and specificity of 95% for identification of LCOS in patients with L-R shunt and PAH (AUC: 0.98, 95% CI: 0.95-1.02, p<0.01). High preoperative sICAM-1 molecule may be used to predict postoperative dichotomous outcome in patients with PAH associated with L-R shunt.