title: Plasma corin decreases after coronary artery bypass graft surgery and is associated with postoperative heart failure: a pilot study.
abstract: OBJECTIVE
  Corin is a natriuretic peptide-converting enzyme that cleaves precursor pro-B-type natriuretic peptide to active B-type natriuretic peptide (BNP) (diuretic, natriuretic, and vasodilatory properties). Increased plasma BNP is a known diagnostic and prognostic heart failure (HF) biomarker in ambulatory and surgical patients. Recent studies indicate that plasma corin is decreased significantly in chronic HF patients, yet perioperative plasma corin concentrations have not been assessed in cardiac surgical patients. The objectives of this study were to determine the effect of coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) on plasma corin concentrations and to assess the association between change in perioperative plasma corin concentration and long-term postoperative HF hospitalization or death. It was hypothesized that plasma corin concentrations decrease significantly from preoperative baseline during postoperative days 1 to 4 and that hospitalization or death from HF during the 5 years after surgery is associated with higher relative difference (preoperative baseline to postoperative nadir) in plasma corin concentrations.
  
  
  METHODS
  Prospective observational pilot study.
  
  
  METHODS
  Two institutions: Brigham and Women's Hospital, Boston, Massachusetts and the Texas Heart Institute, St. Luke's Hospital, Houston, Texas.
  
  
  METHODS
  99 patients of European ancestry who underwent isolated primary CABG surgery with CPB.
  
  
  METHODS
  Nonemergency isolated primary CABG surgery with CPB.
  
  
  RESULTS
  Plasma corin concentration was assessed preoperatively and at 4 postoperative time points (postoperative days 1-4). HF hospitalization or HF death events during the 5 years after surgery were identified by review of hospital and death records. Postoperative plasma corin concentrations were significantly lower than preoperative baseline concentrations (p<0.0001). Perioperative corin concentrations were significantly higher in males than in females (p<0.0001). Fifteen patients experienced long-term postoperative HF events. Patients who experienced HF hospitalization or HF death during study follow-up had significantly higher relative difference in plasma corin concentration (preoperative baseline to postoperative nadir) than patients who did not experience HF events during study follow-up (p=0.03).
  
  
  CONCLUSIONS
  Plasma corin concentrations decrease significantly from preoperative concentrations after CABG surgery. HF hospitalization or HF death during the 5 years after CABG surgery with CPB is associated with larger relative decrease in plasma corin concentration from preoperative baseline. Further investigation is warranted to determine the role of corin in postoperative HF biology.
authors: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Anesthesiology, Fairfax Anesthesia Associates of American Anesthesiology and Virginia Commonwealth University Medical School INOVA campus, Falls Church, Virginia. Electronic address: caryn.barnet@gmail.com.
authors: Caryn S
authors: CS
authors: Barnet
authors: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors: Xiaoxia
authors: X
authors: Liu
authors: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors: Simon C
authors: SC
authors: Body
authors: Division of Cardiovascular Anesthesia, Texas Heart Institute, St. Luke's Hospital, Houston, TX.
authors: Charles D
authors: CD
authors: Collard
authors: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors: Stanton K
authors: SK
authors: Shernan
authors: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors: Jochen D
authors: JD
authors: Muehlschlegel
authors: Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors: Petr
authors: P
authors: Jarolim
authors: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX.
authors: Amanda A
authors: AA
authors: Fox
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011183:Postoperative Complications / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D011446:Prospective Studies; D012697:Serine Endopeptidases / Q000097:blood*; D015996:Survival Rate / Q000639:trends
chemical_list: D015415:Biomarkers; C119812:CORIN protein, human; D012697:Serine Endopeptidases
keywords: biologic markers; cardiac surgery; corin protein; coronary artery bypass grafting; heart failure; human corin; natriuretic peptide
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