Evaluation of Cardiac Biomarkers as Predictors of Short-Term Mortality Following Coronary Artery Bypass Grafting

Background: Non-communicable diseases (NCDs), particularly cardiovascular diseases (CVDs) like coronary heart disease (CHD), are the leading cause of global mortality. Despite advancements in diagnostic and therapeutic interventions, CHD remains a significant healthcare challenge. Coronary artery bypass grafting (CABG) is a widely used surgical intervention for advanced CHD, but postoperative mortality remains a concern. Biomarkers such as N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity troponin I (HS troponin I), and creatine kinase-myocardial band (CKMB) have been investigated for their prognostic value in predicting CABG outcomes, but their efficacy remains debated. Methods: This single-center retrospective cohort study, conducted at Soetomo General Academic Hospital, Surabaya, Indonesia, evaluated the relationship between preoperative levels of NT-proBNP, HS troponin I, and CKMB with 30-day post-CABG mortality. Participants undergoing CABG with cardiopulmonary bypass (CPB) between January and April 2024 were included. Data collected included biomarker levels (CK-MB, HS-TnI, NT-proBNP), CPB and cross-clamp times, and demographics. Statistical analysis was performed using logistic regression to assess associations with mortality. Results: A total of 31 participants (90.3% male, mean age 59.31 ± 9.11 years) were included. The biomarker levels were as follows: CK-MB (48.03 ± 41.28 U/L), NT-proBNP (875.33 ± 1253.73 pg/mL), and HS troponin I (5.17 ± 5.20 pg/mL). One mortality event (3.2%) occurred. Multivariate analysis showed no significant association between age, sex, or the biomarkers (CK-MB, HS troponin I, NT-proBNP) and mortality (p>0.05 for all). Conclusion: Preoperative levels of CK-MB, HS troponin I, and NT-proBNP were not significantly associated with short-term mortality following CABG in this study. These findings highlight the need for further research to explore additional clinical variables and biomarkers for improving mortality prediction in CABG patients.