MST1 is a candidate biomarker of mortality of emergency surgical repair for acute type A aortic dissection

Abstract

Abstract Background: Acute type A aortic dissection (ATAAD) is a life-threatening pathological change of the aorta. Patients who have undergone aortic surgery are usually at high risk of mortality. Aim: We investigated the predictive value of serum Mammalian sterile 20-like kinase 1 (MST1) as a biomarker for the risk of mortality of ATAAD patients. Methods: In this retrospective cohort study, we analyzed 160 consecutive ATAAD patients who had undergone emergency surgery from July 2016 to April 2017. Medical records and blood samples were collected and analyzed. ELISA assays were performed to detect the concentrations of several proteins including MST1. The relationship between these potential biomarkers and the primary endpoint of death was evaluated using Cox proportional hazard regression analysis. Results: Compared with a low level (<1330.8 ng/L), high serum MST1 level (≥1330.8 ng/L) was positively associated with the 30-day mortality (OR=5.233, 95%CI, 1.843-14.862, P<0.01) and retained predictive after adjustment for sex, age, and BMI (OR=4.993, 95% CI, 1.727-14.435, P<0.01). Kaplan-Meier survival analysis demonstrated a positive correlation between MST1 and the 30-day mortality (P<0.01). A pre-existing basic clinical prediction model was improved with the inclusion of preoperative serum MST1. Specifically, the area under the ROC curve for base model (history of cerebrovascular disease, creatinine, time of operation) was 0.708 (95%CI, 0.546-0.836) and markedly increased to 0.823 when taking MST1 into consideration (95%CI, 0.700-0.912, P=0.02). Conclusion: High preoperative circulating MST1, with a concentration greater than 1330.8 ng/L, was correlated with the 30-day mortality of ATAAD patients who underwent emergency surgery.