Endogenic erythropoietin secretion in patients undergoing off-pump coronary artery bypass grafting

Abstract

A b s t r a c tBackground: Erythropoietin (EPO) deficiency or inadequate EPO secretion in response to bleeding may result in profound or prolonged anaemia after cardiac surgery. Aim:The aim of the study was to evaluate the changes in EPO secretion in patients undergoing off-pump coronary artery bypass grafting (OPCAB).Methods: Blood samples from 43 patients (mean age 65.1 ± 7.6 years) were obtained before surgery and on the 1 st , 2 nd , and 6 th day post isolated OPCAB. EPO levels ≥ 4.3 mIU/mL were considered normal.Results: Thirteen (30%) patients had the preoperative EPO level below normal range even though their preoperative haemoglobin was ≥ 13 g/dL. In patients with basal EPO deficiency lower peak EPO levels were observed compared to the group with normal basal EPO levels, even though reduction in haemoglobin concentrations was comparable in both groups. Moreover, lower reticulocytosis was noted on day 1 (8.5 ± 4.0‰ vs. 11.7 ± 4.4‰; p = 0.04) and a tendency toward lower values was seen on day 2 (9.6 ± 4.3‰ vs. 13.0 ± 5.8‰; p = 0.07) among patients with preoperative EPO deficiency.Conclusions: Erythropoietin deficiency is common in patients scheduled for OPCAB, and it results in diminished increase in EPO secretion in response to bleeding. Consequently, in patients with EPO deficiency, reticulocytosis is lower than it could be predicted based on the observation of patients with normal EPO levels and similar blood loss.

Relationship between Atherosclerosis Risk Factors and Carotid Artery Stenosis in Patients Undergoing Coronary Artery Bypass Graft

“…In Drohomirecka et al's study, it was conducted on 682 patients. 18% of the patients had a stenosis of more than 50% and 4.5% had a stenosis of more than 70% [11]. The prevalence of carotid artery stenosis of more than 50% in CABG patients has been from 2% to 18% in different studies.…”

“…This means that more arterial stenosis was observed in patients with a history of CVA. In Drohomirecka et al's study, the history of CVA was considered one of the independent risk factors of stenosis [11]. The prevalence of previous CVA was 2.6% in Tarzamani et al's study [8].…”

“…Also, in the study of Kiernan et al, the history of previous brain events was identified as one of the important factors of more than 70% of carotid stenosis [12]. Some studies have recommended carotid doppler ultrasound of the carotid arteries before CABG for all candidate patients [11]. In Kiernan et al's study, no significant difference was observed between lipid abnormalities, diabetes mellitus, and carotid artery stenosis.…”

Comprehensive Study of Different Expressed Genes and Their Functional Modules in Anesthesia for Off-Pump Coronary Artery Bypass Grafting

“…One of the potential advantages of OPCABG is to attenuate systemic inflammatory responses caused by neutrophil activation [29]. Moreover, OPCABG is beneficial to the secretion of endogenous erythropoietin in patients, reducing the blood loss of surgery [30]. Studies have found that OPCABG is associated with decreased troponin I levels and activation, while elevated levels of troponin I and proinflammatory cytokines are present in most cardiac surgery patients [31].…”

The evaluation of predictive values of routine blood parameters for carotid artery disease in patients undergoing coronary artery bypass grafting

“…The presence of signif icant preoperative CAS may lead to postoperative neurological complications. [11] Previous studies have shown that MPV, NLR and PLR values, which can be easily obtained from routine blood parameters, can be used in the diagnosis and prognosis of cardiovascular diseases. Platelets play an important role in atherosclerotic cardiovascular diseases.…”