The Biomarkers bio-ADM and DPP3 Complement Post-Cardiac Surgery Diagnostics to Early Detect Organ Failure
- Post-surgical increase of endothelial function biomarker bioactive adrenomedullin (bio-ADM) concentrations predicts organ dysfunction.
- Bio-ADM may help identify patients with an increased risk of developing prolonged vasopressor dependence and prolonged ICU stay after cardiac surgery.
- Increased blood concentrations of cardiac depressant factor dipeptidyl peptidase 3 (DPP3) are related to the complexity and duration of the intervention.
Hennigsdorf, Germany, March 24, 2022 - The diagnostic company SphingoTec GmbH (SphingoTec) announces new evidence supporting the use of innovative biomarkers in the early identification of organ dysfunction and risk stratification of cardiac surgery patients (1). Despite many serious post-operative complications (2), there are currently limited tools available for the early identification of organ dysfunction in these patients (3,4).
Scientists from the Radboud University Medical Center have analyzed the predictive value of bio-ADM and DPP3 for short-term outcomes in a prospective study in cardiac surgery patients. Bio-ADM and DPP3 represent two distinct molecular pathways involved in the development of circulatory shock (5). Compromised hemodynamics after surgery triggers the release of the hormone bio-ADM, a key regulator of endothelial barrier function and vascular tone. The current data shows that bio-ADM at day two after ICU admission effectively differentiated between high-risk and low-risk patients for developing organ failure.
The study data also confirmed the independency of a second pathophysiological process, the release of DPP3 upon cell death. Surgery acts as an additional factor leading to an increase in DPP3 in the bloodstream, which is mainly related to tissue injury and the extent of the procedure. Therefore, elevated levels of DPP3 decrease shortly after the surgery. Not surgery-induced and persistently high concentration of DPP3 signals impaired tissue perfusion and high risk for organ failure (5).
Dr. Andreas Bergmann, founder and CEO of SphingoTec, added, “Cardiac surgery is often accompanied by postoperative complications. By using the innovative biomarkers, clinicians can improve the risk stratification provided by conventional risk scores and improve their patient management.”
- van Lier et al. The value of bioactive adrenomedullin and dipeptidyl peptidase 3 to predict short-term unfavourable outcomes after cardiac surgery: A prospective cohort study. Eur J Anaesthesiol. 2022 Apr 1;39(4):342-351. doi: 10.1097/EJA.0000000000001662.
- Nearman et al. Perioperative complications of cardiac surgery and postoperative care. Crit Care Clin 2014; 30:527–555.
- Paparella et al. Cardiopulmonary bypass induced inflammation: pathophysiology and treatment. An update. Eur J Cardiothorac Surg 2002; 21:232–244.
- Laffey JG, Boylan JF, Cheng DC. The systemic inflammatory response to cardiac surgery: implications for the anesthesiologist. Anesthesiology 2002; 97:215–252
- van Lier D, Kox M, Pickkers P. Promotion of vascular integrity in sepsis through modulation of bioactive adrenomedullin and dipeptidyl peptidase 3. J Intern Med 2020; 289:792–806.