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Int. J. Mol. Sci. 2017, 18(11), 2374; doi:10.3390/ijms18112374

Macrophage Migration Inhibitory Factor Predicts Outcome in Complex Aortic Surgery

1
European Vascular Center Aachen-Maastricht, Department of Vascular Surgery University Hospital Aachen, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
2
Department of Intensive Care and Intermediate Care, University Hospital Aachen, RWTH Aachen University, 52074 Aachen, Germany
3
Department of Medical Statistics, University Hospital Aachen, RWTH Aachen University, 52074 Aachen, Germany
4
Department of Anaesthesia and Intensive Care, University of Rostock, 18059 Rostock, Germany
5
Department of Anesthesiology, University Hospital Aachen, RWTH Aachen University, 52074 Aachen, Germany
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Received: 26 September 2017 / Revised: 27 October 2017 / Accepted: 8 November 2017 / Published: 9 November 2017
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)
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Abstract

The perioperative inflammatory response is associated with outcome after complex aortic repair. Macrophage migration inhibitory factor (MIF) shows protective effects in ischemia-reperfusion (IR), but also adverse pro-inflammatory effects in acute inflammation, potentially leading to adverse outcome, which should be investigated in this trial. This prospective study enrolled 52 patients, of whom 29 (55.7%) underwent open repair (OR) and 23 (44.3%) underwent endovascular repair (ER) between 2014 and 2015. MIF serum levels were measured until 72 h post-operatively. We used linear mixed models and ROC analysis to analyze the MIF time-course and its diagnostic ability. Compared to ER, OR induced higher MIF release perioperatively; at 12 h after ICU admission, MIF levels were similar between groups. MIF course was significantly influenced by baseline MIF level (P = 0.0016) and acute physiology and chronic health evaluation (APACHE) II score (P = 0.0005). MIF level at 24 h after ICU admission showed good diagnostic value regarding patient survival [sensitivity, 80.0% (28.4–99.5%); specificity, 51.2% (35.1–67.1%); AUC, 0.688 (0.534–0.816)] and discharge modality [sensitivity, 87.5% (47.3–99.7%); specificity, 73.7% (56.9–86.6%), AUC, 0.789 (0.644–0.896)]. Increased perioperative MIF-levels are related to an increased risk of adverse outcome in complex aortic surgery and may represent a biomarker for risk stratification in complex aortic surgery. View Full-Text
Keywords: macrophage migration inhibitory factor; thoracoabdominal aortic aneurysm; intensive care unit; survival macrophage migration inhibitory factor; thoracoabdominal aortic aneurysm; intensive care unit; survival
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MDPI and ACS Style

Gombert, A.; Stoppe, C.; Foldenauer, A.C.; Schuerholz, T.; Martin, L.; Kalder, J.; Schälte, G.; Marx, G.; Jacobs, M.; Grommes, J. Macrophage Migration Inhibitory Factor Predicts Outcome in Complex Aortic Surgery. Int. J. Mol. Sci. 2017, 18, 2374.

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