Baylor University Medical Center Proceedings January 2014, Volume 27, Number 1 | Page 75

Selected published abstracts of Baylor researchers
ANNALS OF SURGERY
Serum miR-200c is a novel prognostic and metastasis-predictive
biomarker in patients with colorectal cancer
Toiyama Y, Hur K, Tanaka K, Inoue Y, Kusunoki M, Boland CR, Goel A
Ann Surg 2013 Aug 26 [Epub ahead of print]. Reprinted with
permission from Wolters Kluwer Health.
Objectives: To evaluate the ability of epithelial-to-mesenchymal
transition-related microRNAs (miRNAs) as serum biomarkers for
prognosis and prediction of metastasis in patients with colorectal
cancer (CRC).
Background: Epithelial-to-mesenchymal transition-related miRNAs
drive CRC progression and metastasis. However, their potential as
serum biomarkers in CRC has not been studied.
Methods: This was a 3-phase study using 446 colorectal specimens.
In the first phase, we selected candidate miRNAs associated with
metastasis by analyzing the expression of 4 miR-200 family members
(miR-200b, -200c, -141, and -429) in serum samples from 12 patients
with stage I and IV CRC. The second phase involved independent
validation of candidate miRNAs in serum from 182 patients with
CRC and 24 controls. Finally, we analyzed expression in matched
156 tumor tissues from 182 patients with CRC and an independent
set of 20 matched primary CRC and corresponding liver metastases
to identify the source of circulating miRNAs.
Results: After initial screening, miR-200c was selected as the candidate
serum miRNA best associated with metastasis. Validation analysis
revealed that serum miR-200c levels were significantly higher in stage
IV than in stage I–III CRCs. High serum miR-200c demonstrated
a significant positive correlation with lymph node metastasis, distant
metastasis, and prognosis (P = 0.0026, P = 0.0023, and P = 0.0064,
respectively). More importantly, serum miR-200c was an independent
predictor for lymph node metastasis (odds ratio: 4.81, 95% confidence
interval: 1.98–11.7, P = 0.0005) and tumor recurrence (hazard ratio:
4.51, 95% confidence interval: 1.56–13.01, P = 0.005) and emerged
as an independent prognostic marker for CRC (hazard ratio: 2.67,
95% confidence interval: 1.28–5.67, P = 0.01).
Conclusions: Serum miR-200c has strong potential to serve as a noninvasive biomarker for CRC prognosis and predicting metastasis.

ANNALS OF THORACIC SURGERY
Risk of not being discharged home after isolated coronary artery
bypass graft operations
Edgerton J, Filardo G, Ryan WH, Brinkman WT, Smith RL, Hebeler RF Jr,
Hamman B, Sass DM, Harbor JP, Mack MJ
Ann Thorac Surg 2013;96(4):1287–1292. Reprinted with permission
from Elsevier.
Background: The age and risk profile of patients undergoing isolated coronary artery bypass grafting (CABG) is increasing, which
will likely increase the proportion of CABG patients discharged to
Proc (Bayl Univ Med Cent) 2014;27(1):73–76

nursing homes, rehabilitation, or long-term care. Because discharge
disposition can be important to a patient’s treatment goals, developing
and using predictive tools will improve informed treatment decision
making. We examined the utility of The Society of Thoracic Surgeons
(STS) risk of mortality score in predicting discharge disposition after
CABG.
Methods: From January 1, 2004, to October 31, 2011, 5119 patients
underwent isolated CABG at The Heart Hospital Baylor Plano or
Baylor University Medical Center (Texas) and were discharged alive.
The association between STS risk of mortality and discharge to nursing
home, rehabilitation, or long-term care was assessed using multivariable logistic regression, adjusted for age, body surface area, marital
status, site, and year of operation.
Results: At discharge, 216 patients (4.21%) went to nursing homes,
153 (2.99%) to rehabilitation, and 115 (2.25%) to long-term care.
The STS risk of mortality score was significantly positively associated with discharge status (P < 0.001). Patients with 1%, 2%, 3%,
4%, and 5% STS risk of mortality had 11.25%, 22.10%, 29.45%,
35.00%, and 38.50% probability, respectively, of not being discharged
home. When the STS risk of mortality was 5%, the risk of not being
discharged home was 47.9% for off-pump patients and 38.10% for
on-pump patients.
Conclusions: STS risk score is strongly associated with CABG discharge
status. Patients with a risk score exceeding 2 are at high risk (>22%)
of not being discharged home. This risk should be discussed when
treatment decisions are being made.

ASAIO JOURNAL
Which is better: a miniaturized percutaneous ventricular assist
device or extracorporeal membrane oxygenation for patients
with cardiogenic shock?
Chamogeorgakis T, Rafael A, Shafii AE, Nagpal D, Pokersnik JA,
Gonzalez-Stawinski GV
ASAIO J 2013 Oct 1 [Epub ahead of print]. Reprinted with permission
from Wolters Kluwer Health.
The purpose of this study is to compare outcomes associated with the
use of Impella and TandemHeart short-term support devices with
venoarterial extracorporeal membrane oxygenation (ECMO) therapy
for postinfarction- or decompensated cardiomyopathy-related cardiogenic shock. Between January 2006 and September 2011, 79
patients were supported with either an Impella axial flow pump
(n = 7) or a TandemHeart centrifugal pump (n = 11), or with ECMO
(n = 61) therapy for cardiogenic shock in a single institution. Pertinent variables and postprocedural events were analyzed in this cohort
of patients using a prospectively maintained clinical database. The
in-hospital mortality, successful weaning from mechanical circulatory
support, bridge to long-term destination support device and heart
transplantation, and limb complications did not differ between the
2 groups based on intention-to-treat analysis. Age was the only independent predictor for in-hospital survival. In this cohort of patients,
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