Potential Role of Extracellular CIRP in Total Aortic Arch Replacement under Hypothermic Circulatory Arrest

Objectives. To investigate the potential role of extracellular cold-inducible RNA-binding protein (CIRP) in total aortic arch replacement under hypothermic circulatory arrest. Methods. The serum extracellular CIRP levels at five time points in 96 patients with Stanford A aortic dissection were detected. Overall change trend of CIRP levels at five time points was described, and the risk factors for 30-day mortality after surgery were analyzed. Results. The serum extracellular CIRP levels increased gradually after surgery, starting to rise significantly at approximately 12 h postoperatively, reaching or approaching a peak at approximately 24 h postoperatively, and ceasing to rise significantly after approximately 48 h postoperatively. Age, troponin-I, urodilatin, cooling time, cardiopulmonary bypass time, cross-clamp time, duration of surgery, and CIRP level at the end of surgery in the death group were significantly higher than those in the survival group. Multivariable analysis indicated that CIRP level at the end of surgery, age, urodilatin, and cross-clamp time were independent risk factors for postoperative 30-day mortality. Conclusion. Extracellular CIRP is closely related to the perioperative condition and prognosis of hypothermic circulatory arrest.