title: Biomarkers in Coronary Artery Bypass Surgery: Ready for Prime Time and Outcome Prediction?
abstract: Coronary artery bypass surgery (CABG) is still one of the most frequently performed surgical procedures all over the world. The results of this procedure have been constantly improved over the years with low perioperative mortality rates, with relatively low complication rates. To further improve these outstanding results, the clinicians focused their attention at biomarkers as outcome predictors. Although biological testing for disease prediction has already been discussed many times, the role of biomarkers in outcome prediction after CABG is still controversial. In this article, we reviewed the current knowledge regarding the role of genetic and dynamic biomarkers and their possible association with the occurrence of adverse clinical outcomes after CABG. We also took into consideration that the molecular pathway activation and the possible imbalance may affect hard outcomes and graft patency. We analyzed biomarkers classified in two different categories depending on their possibility to change over time: genetic markers and dynamic markers. Moreover, we evaluated these markers by dividing them, into sub-categories, such as inflammation, hemostasis, renin-angiotensin, endothelial function, and other pathways. We showed that biomarkers might be associated with unfavorable outcomes after surgery, and in some cases improved outcome prediction. However, the identification of a specific panel of biomarkers or of some algorithms including biomarkers is still in an early developmental phase. Finally, larger studies are needed to analyze broad panel of biomarkers with the specific aim to evaluate the prediction of hard outcomes and graft patency.
authors.affiliation: Dipartimento di Scienze Biomediche per la Salute, Università Degli Studi di Milano, Milan, Italy; Unità Operativa di Cardiochirurgia e Ricerca Traslazionale, San Donato IRCCS, San Donato Milanese, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Parolari
authors.affiliation: Centro Cardiologico Monzino IRCCS , Milan , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Poggio
authors.affiliation: Centro Cardiologico Monzino IRCCS , Milan , Italy.
authors.forename: Veronika
authors.initials: V
authors.lastname: Myasoedova
authors.affiliation: Centro Cardiologico Monzino IRCCS, Milan, Italy; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università Degli Studi di Milano, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Songia
authors.affiliation: Centro Cardiologico Monzino IRCCS , Milan , Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Bonalumi
authors.affiliation: Sezione Cardiovascolare, Dipartimento di Scienze Cliniche e di Comunità, Università Degli Studi di Milano , Milan , Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Pilozzi
authors.affiliation: S.Orsola-Malpighi, Dipartimento di Cardiochirurgia, Università di Bologna , Bologna , Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Pacini
authors.affiliation: Centro Cardiologico Monzino IRCCS, Milan, Italy; Sezione Cardiovascolare, Dipartimento di Scienze Cliniche e di Comunità, Università Degli Studi di Milano, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Alamanni
authors.affiliation: Centro Cardiologico Monzino IRCCS, Milan, Italy; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università Degli Studi di Milano, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Tremoli
keywords: biomarkers; coronary artery bypass; dynamic; genetic; outcome