Tags

Type your tag names separated by a space and hit enter

Reduced expression of systemic proinflammatory and myocardial biomarkers after off-pump versus on-pump coronary artery bypass surgery: a prospective randomized study.
J Crit Care. 2010 Jun; 25(2):305-12.JC

Abstract

BACKGROUND

The effects of off-pump (OffPCABG) and on-pump (OnPCABG) coronary artery bypass grafting (CABG) on myocardium and inflammation are unclear.

OBJECTIVE

Compare the inflammatory response and myocardial injury from patients (pts) submitted to OffPCABG with those that undergo OnPCABG.

METHODS

Patients with normal left ventricular function were assigned to OffPCABG (n = 40) and OnPCABG (n = 41). Blood samples were collected before and 24 hours after surgery for determination of creatine kinase (CK)-MB (CK-MB), troponin I (cTnI), interleukin (IL)-6, IL-8, P-selectin, intercellular adhesion molecule (ICAM)-1 and C-reactive protein (CRP). Mortalities were registered at 12 months.

RESULTS

Preoperative CK-MB and cTnI levels were 3.1 +/- 0.6 IU and 1.2 +/- 0.5 ng/mL for OffPCABG and 3.0 +/- 0.5 IU and 1.0 +/- 0.2 ng/mL for OnPCABG pts. Postoperative CK-MB and cTnI levels were 13.9 +/- 6.5 IU and 19.0 +/- 9.0 ng/mL for OffPCABG vs 29.5 +/- 11.0 IU and 31.5 +/- 10.1 ng/mL for OnPCABG (P < .01). OffPCABG and OnPCABG pts had similar preoperative IL-6 (10 +/- 7 and 9 +/- 13 pg/mL), IL-8 (19 +/- 7 and 17 +/- 7 pg/mL), soluble P-selectin (70 +/- 21 and 76 +/- 23 pg/mL), soluble ICAM-1 (117 +/- 50 and 127 +/- 52 ng/mL), and CRP (0.09 +/- 0.05 and 0.11 +/- 0.07 mg/L). At 24 hours, for OffPCABG and OnPCABG: IL-6 was 37 +/- 38 and 42 +/- 41 g/mL; IL-8, 33 +/- 31 and 60 +/- 15 pg/mL; soluble P-selectin, 99 +/- 26 and 172 +/- 30 pg/mL; soluble ICAM-1, 227 +/- 47 and 236 +/- 87 ng/mL; and CRP, 10 +/- 11 and 14 +/- 13 mg/L (P < .01 vs preoperation; P < .01 vs OffPCABG). Increased 24-hour postoperative CRP levels was the only marker to have significant positive correlations with events and occurred just for the OnPCABG pts. In-hospital and 1-year mortalities for the OnPCABG and OffPCABG pts were 2.0% and 2.2% (P = .1) and 2.7% and 4.7% (P = .06), respectively.

CONCLUSIONS

Thus, the absence of CPB during CABG preserves better the myocardium and attenuates inflammation-however, without improving survival.

Authors+Show Affiliations

Heart Institute (InCor), Medical School, University of São Paulo, Brazil 05403-901. carlos.serrano@incor.usp.brNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19781902

Citation

Serrano, Carlos V., et al. "Reduced Expression of Systemic Proinflammatory and Myocardial Biomarkers After Off-pump Versus On-pump Coronary Artery Bypass Surgery: a Prospective Randomized Study." Journal of Critical Care, vol. 25, no. 2, 2010, pp. 305-12.
Serrano CV, Souza JA, Lopes NH, et al. Reduced expression of systemic proinflammatory and myocardial biomarkers after off-pump versus on-pump coronary artery bypass surgery: a prospective randomized study. J Crit Care. 2010;25(2):305-12.
Serrano, C. V., Souza, J. A., Lopes, N. H., Fernandes, J. L., Nicolau, J. C., Blotta, M. H., Ramires, J. A., & Hueb, W. A. (2010). Reduced expression of systemic proinflammatory and myocardial biomarkers after off-pump versus on-pump coronary artery bypass surgery: a prospective randomized study. Journal of Critical Care, 25(2), 305-12. https://doi.org/10.1016/j.jcrc.2009.06.009
Serrano CV, et al. Reduced Expression of Systemic Proinflammatory and Myocardial Biomarkers After Off-pump Versus On-pump Coronary Artery Bypass Surgery: a Prospective Randomized Study. J Crit Care. 2010;25(2):305-12. PubMed PMID: 19781902.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced expression of systemic proinflammatory and myocardial biomarkers after off-pump versus on-pump coronary artery bypass surgery: a prospective randomized study. AU - Serrano,Carlos V,Jr AU - Souza,Juliana A, AU - Lopes,Neuza H, AU - Fernandes,Juliano L, AU - Nicolau,José Carlos, AU - Blotta,Maria Heloísa S L, AU - Ramires,José Antônio F, AU - Hueb,Whady A, Y1 - 2009/09/24/ PY - 2009/01/05/received PY - 2009/05/10/revised PY - 2009/06/04/accepted PY - 2009/9/29/entrez PY - 2009/9/29/pubmed PY - 2010/7/28/medline SP - 305 EP - 12 JF - Journal of critical care JO - J Crit Care VL - 25 IS - 2 N2 - BACKGROUND: The effects of off-pump (OffPCABG) and on-pump (OnPCABG) coronary artery bypass grafting (CABG) on myocardium and inflammation are unclear. OBJECTIVE: Compare the inflammatory response and myocardial injury from patients (pts) submitted to OffPCABG with those that undergo OnPCABG. METHODS: Patients with normal left ventricular function were assigned to OffPCABG (n = 40) and OnPCABG (n = 41). Blood samples were collected before and 24 hours after surgery for determination of creatine kinase (CK)-MB (CK-MB), troponin I (cTnI), interleukin (IL)-6, IL-8, P-selectin, intercellular adhesion molecule (ICAM)-1 and C-reactive protein (CRP). Mortalities were registered at 12 months. RESULTS: Preoperative CK-MB and cTnI levels were 3.1 +/- 0.6 IU and 1.2 +/- 0.5 ng/mL for OffPCABG and 3.0 +/- 0.5 IU and 1.0 +/- 0.2 ng/mL for OnPCABG pts. Postoperative CK-MB and cTnI levels were 13.9 +/- 6.5 IU and 19.0 +/- 9.0 ng/mL for OffPCABG vs 29.5 +/- 11.0 IU and 31.5 +/- 10.1 ng/mL for OnPCABG (P < .01). OffPCABG and OnPCABG pts had similar preoperative IL-6 (10 +/- 7 and 9 +/- 13 pg/mL), IL-8 (19 +/- 7 and 17 +/- 7 pg/mL), soluble P-selectin (70 +/- 21 and 76 +/- 23 pg/mL), soluble ICAM-1 (117 +/- 50 and 127 +/- 52 ng/mL), and CRP (0.09 +/- 0.05 and 0.11 +/- 0.07 mg/L). At 24 hours, for OffPCABG and OnPCABG: IL-6 was 37 +/- 38 and 42 +/- 41 g/mL; IL-8, 33 +/- 31 and 60 +/- 15 pg/mL; soluble P-selectin, 99 +/- 26 and 172 +/- 30 pg/mL; soluble ICAM-1, 227 +/- 47 and 236 +/- 87 ng/mL; and CRP, 10 +/- 11 and 14 +/- 13 mg/L (P < .01 vs preoperation; P < .01 vs OffPCABG). Increased 24-hour postoperative CRP levels was the only marker to have significant positive correlations with events and occurred just for the OnPCABG pts. In-hospital and 1-year mortalities for the OnPCABG and OffPCABG pts were 2.0% and 2.2% (P = .1) and 2.7% and 4.7% (P = .06), respectively. CONCLUSIONS: Thus, the absence of CPB during CABG preserves better the myocardium and attenuates inflammation-however, without improving survival. SN - 1557-8615 UR - https://www.unboundmedicine.com/medline/citation/19781902/Reduced_expression_of_systemic_proinflammatory_and_myocardial_biomarkers_after_off_pump_versus_on_pump_coronary_artery_bypass_surgery:_a_prospective_randomized_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0883-9441(09)00140-3 DB - PRIME DP - Unbound Medicine ER -