Malondialdehyde kinetics following coronary artery bypass grafting and its relation to osteopontin (original) (raw)
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Interactive cardiovascular and thoracic surgery, 2006
In contrast to conventional on-pump coronary artery bypass grafting only mild increase of parameters of oxidative stress is reported during and after off-pump coronary artery bypass grafting. In an attempt to reduce the side effects of extra corporeal circulation the mini- extra corporeal circulation concept was introduced. In this study peroperative oxidative stress biomarkers were compared using three different techniques for CABG (conventional, mini and off-pump). It concerns a prospective randomized pilot study of 60 aged patients (70+ years) divided over 3 study groups. During the peroperative time points there was a significant increase in the mean concentration of uric acid for the CCABG group. On arrival at the intensive care unit the mean concentrations decreased significantly. During the per-operative period all groups showed significant increase in the concentration of malondialdehyde, however, this increase was the steepest for the CCABG group. On arrival at the intensiv...
American Journal of Biochemistry and Biotechnology, 2021
Traditional Coronary Artery Bypass Graft (CABG) is currently among of the chief methods in dealing with patients suffering from atherosclerotic coronary heart disease. The current study aimed to measure and compare the levels of proinflammatory cytokines and oxidative stress marker in patients who underwent multivessels Minimally Invasive Coronary Artery Bypass Graft Surgery (MICS-CABG) versus off-pump Coronary Artery Bypass Grafting (off-pump CABG) in the cardiothoracic department, Assiut University hospitals, Upper Egypt. the study included 67 patients, all of them suffering from atherosclerotic coronary artery disease, which confirm by cardiac catheter angiography. The patients were divided randomly into two groups, first group (A) included 34 patients to whom Multi Vessels Coronary Artery Bypass Graft Surgery (MICS-CABG) under off pump had been done. The second group (B) included 33 patients whom underwent off pump Coronary Artery Bypass Grafting (off-pump CABG). Tumor Necrosis Factor-Α (TNF-α), interlukin-2 (IL-2), lipid peroxides, Superoxide Dismutase (SOD), total thiols and Nitric Oxide (NO) were estimated in sera of all patients by their corresponding methods; 48 h before the operation, 15 min before the operation end and 72 h after the operation. After testing the normality, Mann-Whitney U test and Spearman correlation coefficient were used to compare the two groups and tested the variables' correlations with the duration of the operation. p≤0.05 was considered significant. Serum TNF-α, IL-2 and lipid peroxides levels were significantly higher while total thiols and SOD were significantly lower, intraoperative and postoperatively, while No was significantly higher intraoperative only, in off-pump CABG group compared to MICS-CABG group and in both groups, intraoperative and postoperatively compared to preoperative levels. Especially in the postoperative samples, TNF-α, IL-2 and NO levels correlated positively while those of SOD correlated negatively with the operation duration the clinical data obtained presented in details in the result sector and revealed that. MICS-CABG group associated with less postoperative pain, less need for blood transfusion, less hospital stays and rapid regain to normal activity. The current study revealed that MICS-CABG is an effective procedure that is associated with small surgical trauma and lower inflammations and oxidative stress compared to off-pump CABG.
European Journal of Cardio-Thoracic Surgery, 2014
OBJECTIVES: Elevated asymmetric dimethylarginine (ADMA) is associated with an increased risk of coronary artery disease. A prognostic value of ADMA following coronary artery bypass grafting (CABG) is unknown. The aim of the current study was to assess the effect of CABG on ADMA and oxidative stress and determine their associations with postoperative complications. METHODS: In 158 consecutive patients (35 women, 123 men, aged 65.2 ± standard deviation 8.2 years) undergoing isolated, elective CABG procedure, we measured plasma ADMA and 8-iso-prostaglandin F 2α (8-iso-PGF 2α) preoperatively and twice postoperatively: 18-36 h and 5-7 days after surgery. The primary end points were postoperative myocardial infarction (PMI) and in-hospital cardiovascular death. RESULTS: ADMA increased from 0.56 ± 0.06 μmol/l at baseline by 68% to 0.94 ± 0.11 μmol/l at 18-36 h after CABG, and then decreased by 20% to 0.75 ± 0.12 μmol/l on 5-7 days postoperatively (P = 0.0001 for all comparisons). A similar pattern of changes was observed for 8-iso-PGF 2α. Thirteen (8.2%) patients developed PMI, and 6 patients (3.8%) died during the early postoperative period because of extensive PMI. PMI and early perioperative mortality were positively associated with ADMA and 8-iso-PGF 2α. CONCLUSIONS: A marked increase of ADMA and oxidative stress is observed within the first days following CABG, and is associated with unfavourable early post-CABG outcomes, including PMI and in-hospital cardiovascular death.
World Journal of Cardiovascular Surgery, 2020
Background: Coronary artery bypass grafting (CABG) is an important modality of treatment for ischemic heart disease. Both off-pump and on-pump CABG have direct effect on the level cardiac biomarkers in the perioperative period. The use of cardiopulmonary bypass (CPB) and aortic cross-clamping may cause additive myocardial damage leading to further elevation of blood markers. The present study is aimed at measuring and comparing the cardiac biomarker levels in immediate post-operative period after on-pump CABG (ONCAB) and off-pump CABG (OPCAB). Methods: All the patients who underwent CABG from January 2015 to June 2016 on elective or emergency basis at Nilratan Sircar Medical College & Hospital have been included in the study. Total 106 patients were operated for CABG of which 75 patients were operated for OPCAB and 31 patients were operated for ONCAB. For the comparison of data the blood markers Troponin-T (Trop-T) and Creatine Kinase-MB (CK-MB) are measured during anesthesia before surgery, post-operatively after 1 hour, post-operatively after 4 hours and post-operatively after 20 hours. All recorded data are analyzed using standard statistical methods. Results: We found the markers are elevated immediately after surgery and gradually come down within 24 hours after surgery in both OPCAB and ONCAB groups. The elevation is more after ONCAB than OPCAB group in immediate post-operative period but the difference is not significant after 20 hours of surgery. Conclusion: Elevated levels of cardiac biomarkers in the immediate post-operative period indicate myocardial damage during surgery, especially after ONCAB in comparison to OPCAB.
Heart Surgery Forum, 2014
Background: It has been suggested that off-pump coronary artery bypass grafting (CABG) surgery reduces myocardial ischemia-reperfusion injury, postoperative systemic inflammatory response, and oxidative stress. The aim of this study was to measure serum malondialdehyde (MDA), highsensitivity C-reactive protein (hs-CRP), M30, and M65 levels and to investigate the relationship between M30 levels and oxidative stress and inflammation in patients undergoing onand off-pump CABG surgery. Methods: Fifty patients were randomly assigned to onpump or off-pump CABG surgery (25 patients off-pump and 25 on-pump CABG surgery), and blood samples were collected prior to surgery, and 30 minutes, 60 minutes, 6 hours, and 24 hours after CABG surgery. Results: Compared to the on-pump group, serum MDA levels at 30 minutes, 60 minutes, 6 hours, and 24 hours after the CABG surgery were significantly lower in the off-pump group (P = .001, P = .001, P = .001, and P = .001, respectively). Serum M30 levels were found to be elevated in both groups, returning to baseline at 24 hours. When compared to baseline, the hs-CRP level reached its peak at 24 hours at 13.28 ± 5.32 mg/dL in the on-pump group, and 15.44 ± 4.02 mg/dL in the off-pump group. Conclusion: CABG surgery is associated with an increase in inflammatory markers and serum M30 levels, indicating epithelial/endothelial apoptosis in the early period.
Clinical Biochemistry, 2012
Objectives: Osteopontin (OPN) is a multifunctional protein associated with vascular injury and has been linked to atherosclerosis and inflammation. We sought to investigate whether OPN changes in relation to coronary artery bypass grafting (CABG) surgery. Design and methods: We studied 50 consecutive patients (63 ± 10 years old, 6 women and 44 men) undergoing elective CABG. Plasma OPN levels were determined by an enzyme-linked immunosorbent assay at baseline and in 24 and 72 h, post-operatively. Cardiac enzymescreatine kinase, the MB isoenzyme of creatine kinase, troponin-I-and C-reactive protein (CRP) were also determined at all three time points. Results: OPN levels 72 h post-op decreased significantly compared to pre-op and 24 h post-op levels (p b 0.001) whereas there was no difference between the pre-op and first post-op values (p = 0.57). The relative change in OPN levels between pre-op and 72 h post-op correlated negatively with absolute troponin-I levels at 72 h post-op (− 0.51, p = 0.005). OPN levels 72 h post-op correlated significantly with CRP at baseline (r = 0.73, p = 0.002). Conclusions: OPN plasma concentrations decreased after CABG surgery in the early post-operative period. The significance of this observation needs further investigation.
Journal of critical …, 2010
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 b .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 b .01 vs preoperation; † P b .01 vs OffPCABG). Increased 24-hour postoperative CRP levels was the only marker to have significant positive correlations Journal of Critical Care (2010) 25, 305-312 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.
Journal of Critical Care, 2010
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 b .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 b .01 vs preoperation; † P b .01 vs OffPCABG). Increased 24-hour postoperative CRP levels was the only marker to have significant positive correlations Journal of Critical Care (2010) 25, 305-312 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.
Annals of clinical and laboratory science
A prospective study was performed to monitor the postoperative changes in biochemical markers associated with reperfusion injury following (i) cardiopulmonary bypass (CPB) with aortic cross-clamping and cardioplagia (CABG); (ii) CPB with a tissue stabilizing device (SUP.CPB); or (iii) surgery on beating heart (off-pump CABG or OPCABG). Of the 48 patients, 16 were subjected to CABG, 16 to SUP.CPB, and 16 to OPCABG. Arterial and venous blood samples drawn 10 min preoperatively and 0.2, 4, 24, and 48 hr after surgery were assayed for plasma lactate, total calcium, and ionized calcium and erythrocyte glutathione peroxidase (GPX) and superoxide dismutase (SOD). Results revealed that ionized calcium, SOD, and GPX levels of all patients increased at 4 hr following surgery but returned to baseline levels at 24 or 48 hr after surgery. Increased postoperative GPX levels reflect a cellular defense mechanism against oxidative damage during reperfusion, while lactate levels during reperfusion reflect delayed recovery of aerobic myocardial metabolism. The postoperative release of lactate, GPX, and SOD in patients undergoing the CABG (on-pump) technique was significantly higher compared to those subjected to OPCABG or SUP.CPB. There were no significant differences in postoperative patterns of release of biomarkers in patients with OPCABG vs SUP.CPB, suggesting that these surgical techniques are equally acceptable.