மருத்துவ மற்றும் பரிசோதனை இருதயவியல்
திறந்த அணுகல்
ஐ.எஸ்.எஸ்.என்: 2155-9880
ஐ.எஸ்.எஸ்.என்: 2155-9880
Stojkovic Branislav, Vukovic Petar, Milojevic Predrag, Jovanovic Toma, Calija Branko, Maravic-Stojkovic Vera, Djukanovic Bosko and Jelena Marinkovic
Background: Determination of biomarkers can assess cardiac injury induced by cardiopulmonary bypass (CPB) during coronary artery bypass grafting (CABG). Open heart surgery initiates inflammatory reaction. Aim of this study was to compare the inflammatory response in patients undergoing first- and CABG-reoperation.
Methods: Fifty-four patients (16% female, 84% male; 60.5 ± 6.5 vs. 66.2 ± 7.3 years) scheduled for elective cardiac surgery were divided into: Group 1, CABG primo-operation, and Group 2, CABG re-operation (redo CABG). The extent of inflammation was estimated by measuring interleukin (IL)-6 and highly sensitive C-reactive protein (hs- CRP) in plasma. Blood samples were collected: 24 hours prior, 6, and 24 hours after initiation of CPB. Demographic data, preoperative risk assessment Euro-score, laboratory values and clinical outcomes: atrial fibrillation rate, tracheal intubation time, revisions, blood loss, length of Intensive Care Unit (ICU) and hospital stay were analyzed.
Results: Baseline levels of IL-6 (p < 0.001) were significantly higher in re-operated patients. IL-6 increased significantly 6 hours after initiation of CPB in both groups (p < 0.0001). Day after surgery IL-6 (p = 0.472) and hs- CRP (p = 0.248) levels were similar in both groups. Although hs-CRP was higher in Group 1 (90.45 ± 46.67 vs. 72.91 ± 57.31 mg/L) this had no statistical significance. Clinical outcomes have been in positive correlations with inflammation, but statistically insignificant in both groups.
Conclusion: Monitoring of IL-6 and hs-CRP during redo CABG has shown that CPB cause inflammatory reaction but repeated use does not cause extensive reaction potentially harmful for myocardium.