Coronary artery bypass grafting surgery is associated with a marked reduction in serum homocysteine and folate levels in the early postoperative period

Storti, Simona; Cerillo, Alfredo Giuseppe; Rizza, Antonio; Giannelli, I.; Fontani, G.; Glauber, Mattia; Clerico, A.

doi:10.1016/j.ejcts.2004.06.001

Cited by 12 publications

(7 citation statements)

References 12 publications

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“…Storti et al described that the level of total plasma protein decreases from 7,3 g/dl before to 4,8 g/dl after CABG. The level of total plasma protein remains decreased to 6 months after surgery [55]. In our study we also found decrease of total plasma protein concentration maintaining in postoperative period.…”

Section: Discussionsupporting

confidence: 79%

Dynamic changes of paraoxonase 1 activity towards paroxon and phenyl acetate during coronary artery surgery

Wysocka

Cybulski

Berbeć

et al. 2017

BMC Cardiovasc Disord

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BackgroundSerum paraoxonase 1 (PON1), an enzyme associated with high – density lipoproteins (HDL) particles, inhibits the oxidation of serum lipoproteins and cell membranes. PON1 activity is lower in patients with atherosclerosis and in inflammatory diseases. The systemic inflammatory response provoked during cardiopulmonary bypass grafting may contribute to the development of postoperative complications. The aim of the present study was to estimate the dynamic changes in paraoxonase 1 (PON1) activity towards paraoxon and phenyl acetate during and after coronary artery surgery.MethodsTwenty six patients with coronary heart disease undergoing coronary artery bypass grafting (CABG) were enrolled into the study. Venous blood samples were obtained preoperatively, after aortic clumping, after the end of operation, at 6, 18, 30 and 48 h after operation. Paraoxonase activity was measured spectrophotometrically in 50 mM glycine/NaOH buffer (pH 10.5) containing 1.0 mM paraoxon, and 1.0 mM CaCl2. Arylesterase activity was measured in 20 mM TrisCl buffer (pH 8.0) containing 1 mM phenyl acetate and 1 mM CaCl2.ResultsPON1 activity toward paraoxon and phenyl acetate significantly decreased after aorta cross clumping and increased directly after operation. PON1 activity towards paraoxon in preoperative period and PON1 activity towards phenyl acetate in seventh stage of experiment tended to inversely correlate with the occurrence of postoperative complications.ConclusionThe paraoxonase 1 plasma activity is markedly reduced during CABG surgery.

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Section: Discussionsupporting

confidence: 79%

Dynamic changes of paraoxonase 1 activity towards paroxon and phenyl acetate during coronary artery surgery

Wysocka

Cybulski

Berbeć

et al. 2017

BMC Cardiovasc Disord

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“…The increased consumption of glutathione during oxidative stress results in increased consumption of homocysteine (Hcy) [35], a potent inhibitor of the ADMA metabolising enzyme dimethylarginine-dimethylaminohydrolase (DDAH) [36]. Thus, a postoperative decrease of Hcy as a consequence of oxidative stress leads to an increased metabolism of ADMA by DDAH.…”

Section: Discussionmentioning

confidence: 99%

The Importance of Intraoperative Selenium Blood Levels on Organ Dysfunction in Patients Undergoing Off-Pump Cardiac Surgery: A Randomised Controlled Trial

et al. 2014

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IntroductionCardiac surgery is accompanied by an increase of oxidative stress, a significantly reduced antioxidant (AOX) capacity, postoperative inflammation, all of which may promote the development of organ dysfunction and an increase in mortality. Selenium is an essential co-factor of various antioxidant enzymes. We hypothesized a less pronounced decrease of circulating selenium levels in patients undergoing off-pump coronary artery bypass (OPCAB) surgery due to less intraoperative oxidative stress.MethodsIn this prospective randomised, interventional trial, 40 patients scheduled for elective coronary artery bypass grafting were randomly assigned to undergo either on-pump or OPCAB-surgery, if both techniques were feasible for the single patient. Clinical data, myocardial damage assessed by myocard specific creatine kinase isoenzyme (CK-MB), circulating whole blood levels of selenium, oxidative stress assessed by asymmetric dimethylarginine (ADMA) levels, antioxidant capacity determined by glutathionperoxidase (GPx) levels and perioperative inflammation represented by interleukin-6 (IL-6) levels were measured at predefined perioperative time points.ResultsAt end of surgery, both groups showed a comparable decrease of circulating selenium concentrations. Likewise, levels of oxidative stress and IL-6 were comparable in both groups. Selenium levels correlated with antioxidant capacity (GPx: r = 0.720; p<0.001) and showed a negative correlation to myocardial damage (CK-MB: r = −0.571, p<0.001). Low postoperative selenium levels had a high predictive value for the occurrence of any postoperative complication.ConclusionsOPCAB surgery is not associated with less oxidative stress and a better preservation of the circulating selenium pool than on-pump surgery. Low postoperative selenium levels are predictive for the development of complications.Trial registrationClinicalTrials.gov NCT01409057

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“…Storti et al 22 studied the changes in homocysteine levels in a population of patient who underwent coronary revascularization. They detected a mean pre-operative value (17.3 µmol/L) higher than the one found in the present study for coronary patients.…”

Section: Discussionmentioning

confidence: 99%

Pre-operative homocysteine levels and morbidity and mortality following cardiac surgery

Ranucci

Ballotta

Frigiola

et al. 2008

European Heart Journal

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AimsElevated homocysteinaemia is associated not only with an increased risk for cardiovascular disease but also for increased morbidity and mortality in patients with established coronary artery or cerebrovascular disease. Whether elevated homocysteine further increases the morbidity and mortality in patients undergoing cardiac surgery on cardiopulmonary bypass (CPB) (a prothrombotic state itself) remains less known.Methods and resultsAccordingly, we conducted a prospective observational study with pre-operative measurement of plasma homocysteine levels in 531 consecutive patients undergoing cardiac operations on CPB. The association of pre-operative plasma homocysteine levels with post-operative morbidity and hospital mortality was evaluated. Elevated homocysteine levels (>15 µmol/L) were observed in 209 patients (39.4%), and homocysteinaemia was associated with a higher mortality and perioperative morbidity (major morbidity, low cardiac output, acute renal failure, mesenteric infarction, and thrombo-embolic events). Even after accounting for the differences in baseline clinical features, EuroSCORE, and CPB time, pre-operative homocysteine levels remained independently associated with hospital mortality [odds ratio (OR) 1.06, 95% confidence interval (CI) 1.03–1.11], major morbidity (OR 1.04, 95% CI 1.01–1.07), low cardiac output (OR 1.04, 95% CI 1.02–1.08), mesenteric infarction (OR 1.06, 95% CI 1.01–1.11), and thrombo-embolic events (OR 1.09, 95% CI 1.04–1.13). This association of homocysteine with increased risk of morbidity and mortality was observed particularly in CABG patients.ConclusionElevated pre-operative homocysteine level is independently associated with increased morbidity and mortality, particularly in patients undergoing CABG. Specific post-operative antithrombotic strategies may be advisable in hyperhomocysteinaemic patients.

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Coronary artery bypass grafting surgery is associated with a marked reduction in serum homocysteine and folate levels in the early postoperative period

Cited by 12 publications

References 12 publications

Dynamic changes of paraoxonase 1 activity towards paroxon and phenyl acetate during coronary artery surgery

Dynamic changes of paraoxonase 1 activity towards paroxon and phenyl acetate during coronary artery surgery

The Importance of Intraoperative Selenium Blood Levels on Organ Dysfunction in Patients Undergoing Off-Pump Cardiac Surgery: A Randomised Controlled Trial

Pre-operative homocysteine levels and morbidity and mortality following cardiac surgery

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