Cardiovascular Journal of Africa: Vol 32 No 5 (SEPTEMBER/OCTOBER 2021)

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 32, No 5, September/October 2021 AFRICA 243 Pericardial SCUBE1 levels may help predict postoperative results in patients operated on for coronary artery bypass graft surgery Taha Özkara, Volkan Yüksel, Orkut Güçlü, Serhat Hüseyin, Eray Özgün, Fatma Nesrin Turan, Suat Canbaz Abstract Introduction: Signal peptide-CUB epidermal growth factor- like domain-containing protein (SCUBE1) is a newly described, secretable and measurable cellular surface protein associated with atherosclerotic lesions in humans, which may be involved in hypertension and cardiovascular pathologies. We aimed to detect normal SCUBE1 levels in pericardial fluid and investigate the effects of SCUBE1 values on postopera- tive outcomes after coronary artery bypass surgery. Methods: Between February 2016 and March 2017, 184 consecutive patients were included in the study. Group 1 consisted of patients with unstable angina pectoris, group 2 of patients with non-ST-elevation myocardial infarction, group 3 of patients with ST-elevation myocardial infarction, and group 4 consisted of patients operated on due to non-coro- nary reasons. Pericardial fluid and arterial blood SCUBE1 values, demographic variables and postoperative results were noted and compared. Results: Normal SCUBE1 level in pericardial fluid was 0.049 ± 0.061 ng/ml. Arterial SCUBE1 levels of smokers were high- er. Pericardial SCUBE1 levels were higher in patients requiring postoperative intra-aortic balloon pump support and patients needing peri-operative temporary cardiac pacing. High peri- cardial SCUBE1 values did not correlate with postoperative stroke, prolonged intensive care unit stay and mortality. Conclusion: High levels of pericardial SCUBE1 may help us predict the need for postoperative intra-aortic balloon pump support and the need for temporary cardiac pacing, however they were not helpful in predicting prolonged intensive care unit stay and early postoperative mortality. Keywords: coronary artery bypass surgery, SCUBE 1, postopera- tive complication Submitted 4/11/19, accepted 9/5/21 Published online 5/7/21 Cardiovasc J Afr 2021; 32 : 243–247 www.cvja.co.za DOI: 10.5830/CVJA-2021-020 Several factors may affect postoperative mortality and morbidity after coronary artery bypass (CAGB) surgery, such as the patient’s age and gender, the presence of additional diseases and ejection fraction. 1,2 Some biochemical parameters may also assist in predicting postoperative outcomes. 3,4 One of these biochemical parameters may be signal peptide-CUB (complement C1r/C1s, Uegf and Bmp-1) epidermal growth factor (EGF)-like domain- containing protein (SCUBE1). SCUBE1 is a newly described, secretable and measurable cellular surface protein associated with early embryogenesis. 5 SCUBE1 is histologically present in subendothelial matrices of atherosclerotic lesions in humans, which also suggests that it may be involved in hypertension and cardiovascular pathologies. Pericardial fluid not only functions as a mechanical lubricant, but also as a biologically active compartment of the heart. Our study firstly aimed at measuring normal SCUBE1 levels in pericardial fluid in those who did not have coronary artery disease. Secondly, we compared SCUBE1 values m​ easured from pericardial fluid and arterial blood samples during surgery from patients who had undergone CABG surgery, to investigate the effects on postoperative outcomes. To the best of our knowledge, there are no data available on pericardial fluid SCUBE1 levels. This is the first study in the literature published on normal levels of SCUBE1 in the pericardial fluid of patients without myocardial ischaemia, and the effects of SCUBE1 levels on postoperative outcomes after CABG surgery. Methods With reference to the article by Gunaydın et al ., the estimated minimum number of participants was calculated using power analysis based on a two-sided alpha of 0.05 with a power of 0.8. 6 According to the results of the power analysis, at least 122 cases should be enrolled for the study. All participants provided written informed consent and were assigned to a treatment group. The local ethics committee approved the trial (2015/182) and the study was conducted according to the principles of the Declaration of Helsinki. Two hundred and thirty-seven consecutive patients, who were operated on between February 2016 and March 2017, were screened. One hundred and eighty-four patients who met the inclusion criteria were included in the study. Fifty (21.09%) Cardiovascular Surgery Department, Trakya University, Edirne, Turkey Taha Özkara, MD Volkan Yüksel, MD, drvyuksel@yahoo.com Orkut Güçlü, MD Serhat Hüseyin, MD Suat Canbaz, MD Biochemistry Department, Trakya University, Edirne, Turkey Eray Özgün, MD Biostatistics Department, Trakya University, Edirne, Turkey Fatma Nesrin Turan, MD