Significance of survivin (BIRC5) as a biomarker for the assessmet of preoperative cardiovascular risk in non-cardiac surgeries: Survivin (BIRC5) as a novel cardiac biomarker

Introduction: Survivin (BIRC5) is a member of the inhibitor of apoptosis family of proteins and has a very important role in the so-called 'point of no return' of cell apoptosis. The role of survivin in the development of tumors and autoimmune diseases has already been proven, however, there are increasing evidence that it is also sensitive to the existence of previous ischemic heart disease. Methods: This prospective pilot study included 78 patients who were preparing for one of the major non-cardiac surgeries. Blood was sampled within 7 preoperative days, serum was separated and frozen at -70°C. The level of survivin in serum was measured using the ELISA (Enzyme-linked immunosorbent assay) method, and the results were read on DIAREADER Elx800G. Results: Patients of an average age of 71.46 ± 6.87 years had the median level of survivin 4.56 (0.00-76.78) pg/ml. Survivin has proven to be an excellent predictor of postoperative mortality (P<0.05, ROC/AUC=0.807). Patients were divided into two groups, one group of patients who had cancer and a group of patients who didnt have cancer, and in both groups statistical analysis of the data was conducted (P>0.05, ROC/AUC=0.782; P<0.05, ROC/ AUC=0.825;). After exclusion of extremely high values, the results in both groups were respectively: P<0.001, ROC/AUC=0.831; P<0.05, ROC/AUC=0.825. Conclusion: Survivin is a potential cardiac biomarker and itsspecificity and sensitivity has been demonstrated even in the group of patients who were not suffering from any kind of tumor.