title: Aortic Wall Extracellular Matrix Proteins Correlate with Syntax Score in Patients Undergoing Coronary Artery Bypass Surgery.
abstract: OBJECTIVE
  The SYNTAX score correlate with major cardiovascular events post-revascularization, although the histopathological basis is unclear. We aim to evaluate the association between syntax score and extracellular matrix histological characteristics of aortic punch tissue obtained during coronary artery bypass surgery (CABG). This analysis compares coronary artery bypass surgery patients with High and Low syntax score which were followed up for one year period.
  
  
  RESULTS
  Patients with High (score ≥ 33, (n=77)) and Low Syntax Scores (score ≤ 22, (n=71)) undergoing elective CABG were recruited prospectively. Baseline clinical characteristics and surgical risks were well matched. At 1 year, EMACCE (Sum of cardiovascular death, stroke, congestive cardiac failure, and limb, gut and myocardial ischemia) was significantly elevated in the High syntax group (P=0.022). Mass spectrometry (MS)-based quantitative iTRAQ proteomic results validated on independent cohort by immunohistochemistry (IHC) revealed that the High syntax group had significantly upraised Collagen I (P<0.0001) and Elastin (P<0.0001) content in ascending aortic wall.
  
  
  CONCLUSIONS
  This study shows that aortic extracellular matrix (ECM) differ between High and Low syntax groups with up-regulation of Collagen I and Elastin level in High Syntax Score group. This identifies aortic punches collected during CABG as another biomarker source related with atherosclerosis severity and possible clinical outcome.
authors.affiliation: Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Terri
authors.initials: T
authors.lastname: Chiong
authors.affiliation: School of Biological Sciences, Nanyang Technological University, Singapore.
authors.forename: Esther S H
authors.initials: ES
authors.lastname: Cheow
authors.affiliation: Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Chin C
authors.initials: CC
authors.lastname: Woo
authors.affiliation: Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore, National University Health System, Singapore.
authors.forename: Xiao Y
authors.initials: XY
authors.lastname: Lin
authors.affiliation: Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Investigational Medicine Unit, National University of Singapore, National University Health System, Singapore.
authors.forename: Lay W
authors.initials: LW
authors.lastname: Khin
authors.affiliation: Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore, National University Health System, Singapore.
authors.forename: Chuen N
authors.initials: CN
authors.lastname: Lee
authors.affiliation: Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore.
authors.forename: Mikael
authors.initials: M
authors.lastname: Hartman
authors.affiliation: School of Biological Sciences, Nanyang Technological University, Singapore.
authors.forename: Siu K
authors.initials: SK
authors.lastname: Sze
authors.affiliation: Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore, National University Health System, Singapore.
authors.forename: Vitaly A
authors.initials: VA
authors.lastname: Sorokin
keywords: Collagen; EMACCE; Elastin; Extracellular matrix; Syntax