Biomarker Skin Autofluorescence Predicts the Outcome in Cardiac Surgery

Objectives: During aging, advanced glycation end products (AGEs) accumulate in extracellular matrix proteins like collagen to a comparable amount in skin as well as in the cardiovascular system and contribute to a systemic decline in organ function. We aimed to assess whether AGE accumulation in the skin measured as skin autofluorescence has a prognostic value for the outcome of cardiac surgery patients.

Methods: Between April 2008 and January 2012, data from 334 consecutive patients undergoing isolated coronary artery bypass grafting were prospectively recorded. Skin autofluorescence was measured using an autofluorescence reader. To verify whether the measured skin autofluorescence correlates with the postoperative outcome in cardiac surgery patients, this parameter was assessed in a multiple logistic regression analysis with other preoperative parameters like age, diabetes, renal function e.g., and the established cardiac surgery risk score systems like the EuroSCORE II and the STS Score.

Results: Skin autofluorescence as non-invasive marker of tissue glycation provided the best prognostic value in identifying patients with major morbidity risks after coronary artery bypass surgery (OR 2.87; p = 0.0004), even better than the established risk scores.

Conclusion: Measurement of the AGE related skin autofluorescence as a non-invasive tool provides incremental prognostic value in identifying patients with major morbidity risks after cardiac surgery.