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Higher levels of serum cytokines and myocardial tissue markers during on-pump versus off-pump coronary artery bypass surgery.
J Card Surg. 2006 Jul-Aug; 21(4):395-402.JC

Abstract

Increased Troponin I levels and pro-inflammatory cytokines have been reported in most patients undergoing cardiac surgery, ascribed to the type and extent of surgery, reperfusion injury, and the method of myocardial protection. We investigated their levels in patients undergoing on-pump (CCAB) or off-pump (OPCAB) coronary artery bypass surgery and whether these correlated with the extent of myocardial injury. One hundred twenty patients were prospectively randomized to undergo OPCAB (n = 60) or CCAB (n = 60). Hemodynamic and respiratory data, as well as serum CK-MB mass fraction, Troponin I, and interleukin (IL)-6, IL-8, and IL-10 levels, were collected perioperatively. Demographic, hemodynamic, and respiratory parameters were similar between the two groups. Troponin I was significantly lower in the OPCAB than in the CCAB group, either at the end of ischemia, end of surgery, 6-hour and 24-hour postoperatively (4 +/- 3, 5 +/- 3, 7 +/- 5, and 8 +/- 3 microg/L, vs. 19 +/- 18, 27 +/- 19, 28 +/- 13.5, and 33 +/- 8.5 microg/L, respectively, p < 0.05). Serum cytokine levels in the OPCAB patients were lower compared to the CCAB group at the end of surgery (32 +/- 35, 25 +/- 30, and 40 +/- 30 pg/ml for IL-6, IL-8, and IL-10 vs. 230 +/- 30, 140 +/- 70, and 125 +/- 50 pg/ml, respectively, p < 0.05). Plasma IL-6 levels correlated with the Troponin I levels at the end of surgery in both groups (r = 0.45, p = 0.01). Thus, OPCAB surgery is associated with reduced levels of Troponin I and activation of cytokines, compared to those in the CCAB group. High levels of these factors could correlate with myocardial damage during coronary artery bypass surgery. This finding warrants further laboratory and clinical confirmation in the future.

Authors+Show Affiliations

Department of Cardiothoracic Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. nachumnesher@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16846420

Citation

Nesher, Nahum, et al. "Higher Levels of Serum Cytokines and Myocardial Tissue Markers During On-pump Versus Off-pump Coronary Artery Bypass Surgery." Journal of Cardiac Surgery, vol. 21, no. 4, 2006, pp. 395-402.
Nesher N, Frolkis I, Vardi M, et al. Higher levels of serum cytokines and myocardial tissue markers during on-pump versus off-pump coronary artery bypass surgery. J Card Surg. 2006;21(4):395-402.
Nesher, N., Frolkis, I., Vardi, M., Sheinberg, N., Bakir, I., Caselman, F., Pevni, D., Ben-Gal, Y., Sharony, R., Bolotin, G., Loberman, D., Uretzky, G., & Weinbroum, A. A. (2006). Higher levels of serum cytokines and myocardial tissue markers during on-pump versus off-pump coronary artery bypass surgery. Journal of Cardiac Surgery, 21(4), 395-402.
Nesher N, et al. Higher Levels of Serum Cytokines and Myocardial Tissue Markers During On-pump Versus Off-pump Coronary Artery Bypass Surgery. J Card Surg. 2006 Jul-Aug;21(4):395-402. PubMed PMID: 16846420.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Higher levels of serum cytokines and myocardial tissue markers during on-pump versus off-pump coronary artery bypass surgery. AU - Nesher,Nahum, AU - Frolkis,Ina, AU - Vardi,Moshe, AU - Sheinberg,Nechama, AU - Bakir,Ihsan, AU - Caselman,Filip, AU - Pevni,Demitri, AU - Ben-Gal,Yanay, AU - Sharony,Ram, AU - Bolotin,Gil, AU - Loberman,Dan, AU - Uretzky,Gideon, AU - Weinbroum,Avi A, PY - 2006/7/19/pubmed PY - 2006/12/21/medline PY - 2006/7/19/entrez SP - 395 EP - 402 JF - Journal of cardiac surgery JO - J Card Surg VL - 21 IS - 4 N2 - Increased Troponin I levels and pro-inflammatory cytokines have been reported in most patients undergoing cardiac surgery, ascribed to the type and extent of surgery, reperfusion injury, and the method of myocardial protection. We investigated their levels in patients undergoing on-pump (CCAB) or off-pump (OPCAB) coronary artery bypass surgery and whether these correlated with the extent of myocardial injury. One hundred twenty patients were prospectively randomized to undergo OPCAB (n = 60) or CCAB (n = 60). Hemodynamic and respiratory data, as well as serum CK-MB mass fraction, Troponin I, and interleukin (IL)-6, IL-8, and IL-10 levels, were collected perioperatively. Demographic, hemodynamic, and respiratory parameters were similar between the two groups. Troponin I was significantly lower in the OPCAB than in the CCAB group, either at the end of ischemia, end of surgery, 6-hour and 24-hour postoperatively (4 +/- 3, 5 +/- 3, 7 +/- 5, and 8 +/- 3 microg/L, vs. 19 +/- 18, 27 +/- 19, 28 +/- 13.5, and 33 +/- 8.5 microg/L, respectively, p < 0.05). Serum cytokine levels in the OPCAB patients were lower compared to the CCAB group at the end of surgery (32 +/- 35, 25 +/- 30, and 40 +/- 30 pg/ml for IL-6, IL-8, and IL-10 vs. 230 +/- 30, 140 +/- 70, and 125 +/- 50 pg/ml, respectively, p < 0.05). Plasma IL-6 levels correlated with the Troponin I levels at the end of surgery in both groups (r = 0.45, p = 0.01). Thus, OPCAB surgery is associated with reduced levels of Troponin I and activation of cytokines, compared to those in the CCAB group. High levels of these factors could correlate with myocardial damage during coronary artery bypass surgery. This finding warrants further laboratory and clinical confirmation in the future. SN - 0886-0440 UR - https://www.unboundmedicine.com/medline/citation/16846420/Higher_levels_of_serum_cytokines_and_myocardial_tissue_markers_during_on_pump_versus_off_pump_coronary_artery_bypass_surgery_ L2 - https://doi.org/10.1111/j.1540-8191.2006.00272.x DB - PRIME DP - Unbound Medicine ER -