Higher Levels of Serum Cytokines and Myocardial Tissue Markers During On-Pump Versus Off-Pump Coronary Artery Bypass Surgery

Nesher, Nahum; Frolkis, Ina; Vardi, Moshe Y.; Sheinberg, Nechama; Bakır, İhsan; Caselman, Filip; Pevni, Dmitry; Ben-Gal, Yanay; Sharony, Ram; Bolotin, Gil; Loberman, Dan; Uretzky, Gideon; Weinbroum, Avi A.

doi:10.1111/j.1540-8191.2006.00272.x

Cited by 66 publications

(32 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The compromised outcomes for patients undergoing CABG with ventricular dysfunction may be in part linked to the use of CPB and the application of cardioplegic solutions to achieve cardiac arrest [4,5].…”

Section: Introductionmentioning

confidence: 99%

Off-pump surgery for the poor ventricle?

et al. 2011

View full text Add to dashboard Cite

Severely decreased ejection-fraction is an established risk-factor for worse outcome after cardiac surgery. We compare outcomes of off-pump coronary artery bypass grafting (OPCAB) and on-pump CABG (ONCABG) in patients with severely compromised EF. From 2004 to 2009, 478 patients with a decreased EF B35% underwent myocardial-revascularization. Patients received either OPCAB (n = 256) or ONCABG (n = 222). Propensity score (PS), including 50 preoperative risk-factors, was used to balance characteristics between groups. PS adjusted logistic regression analysis was performed to assess mortality and major adverse cardiac and cerebrovascular events (MACCE). A composite endpoint for major non-cardiac complications such as respiratory failure, renal failure, rethoracotomy was applied. Complete revascularization (CR) was assumed when the number of distal anastomoses was larger than that of diseased vessels. There was no difference for mortality (2.3 vs. 4.1%; PS-adjusted odds ratio (PS-OR) = 1.05; p = 0.93) and MACCE (13.7 vs. 17.6%; PS-OR = 1.22; p = 0.50) including myocardial-infarction (1.4 vs. 4.9%; PS-OR = 0.39; p = 0.26), low cardiac output (2.3 vs. 4.7%; PS-OR = 0.75; p = 0.72) and stroke (2.3 vs.2.7%; PS-OR = 0.69; p = 0.66). OPCAB patients presented with a trend to less frequent occurrence of the non-cardiac composite (12.1 vs. 22.1%; PS-OR = 0.54; p = 0.059) including renal dysfunction (PAOR = 0.77; 95% CI 0.31-1.9; p = 0.57), bleeding (PAOR = 0.42; 95% CI 0.14-1.20; p = 0.10) and respiratory failure (PAOR = 0.39; 95% CI 0.05-3.29; p = 0.39). The rate of complete revascularization was similar (92.2 vs. 92.8%; PS-OR = 0.75; p = 0.50). OPCAB in patients with severely decreased EF is safe and feasible. It may even benefit these patients in regard to non-cardiac complications and does not come at cost of less complete revascularization.

show abstract

Section: Introductionmentioning

confidence: 99%

Off-pump surgery for the poor ventricle?

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Studies that evaluated the circulating levels of proinflammatory cytokines (IL‐6, ‐8, and ‐10) after off‐ and on‐pump‐ surgery reported contradictory results 14, 18, 19, 20, 21, 22…”

Section: Differences In Systemic Inflammatory Reaction and Platelet/cmentioning

confidence: 99%

Off‐Pump Coronary Artery Bypass Grafting: 30 Years of Debate

Gaudino

Angelini

Antoniades

et al. 2018

JAHA

View full text Add to dashboard Cite

“…[8][9][10] However, these studies dealt with patients who underwent a variety of surgical procedures, including coronary artery bypass grafting (CABG) 9,10) as well as valve surgery including both aortic and mitral valve procedures.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Cardiac Troponin I (cTnI) Level and Its Prognostic Value for Patients Undergoing Mitral Valve Surgery

et al. 2010

View full text Add to dashboard Cite

SummaryIt has previously been reported that cardiac troponin I (cTnI) is useful in predicting the postoperative course after cardiac surgery, and that elevated serum cTnI levels are associated with increased in-hospital mortality. However, these findings have been reported in heterogeneous groups of cardiac surgical procedures. In the current study, the usefulness of postoperative cTnI measurements for the prediction of patient outcomes in a specific group of cardiac surgical procedures was determined, with the analysis limited to patients undergoing mitral valve surgery. The results of cTnI measurements were compared with postoperative creatine kinase-myocardial band fraction (CK-MB) levels.A total of 24 patients who underwent mitral valve surgery from July 2004 to April 2009 were retrospectively studied. Serum cTnI and CK-MB levels were measured on postoperative day (POD) 0 (immediately after surgery), and on POD 1, 2, and 3. The relationship between serum cTnI and CK-MB levels, cardiopulmonary bypass (CPB) time, aorta cross-clamping (AoC) time, and the length of ICU stay and postoperative hospital stay (POHS) were evaluated.CPB and AoC time influenced postoperative cTnI and CK-MB levels. Values of cTnI on POD 1 and POD 2 were significantly correlated with the length of ICU stay, whereas only the CK-MB level on POD 2 was significantly correlated with the length of ICU stay. In addition, the cTnI levels on POD 1 and POD 2 were significantly correlated with POHS, however, there was no relationship between postoperative CK-MB levels and POHS.Postoperative cTnI measurements are more useful than CK-MB measurements in predicting the postoperative course of a patient following mitral valve surgery. (Int Heart J 2010; 51: 166-169) Key words: Troponin I, Creatine kinase-myocardial band fraction (CK-MB), Mitral valve surgery C ardiac troponin, along with creatine kinase (CK) and its myocardial band fraction (CK-MB), are proteins which are released from damaged cardiomyocytes into the interstitial space. 1) They reach the peripheral circulation either by crossing the walls of myocardial capillaries or by diffusing through the epicardium into the pericardial cavity.2,3) Troponin levels are recognized as a sensitive and specific marker for cardiac injury. They are reported to be more accurate than CK-MB levels for the diagnosis of myocardial infarction (MI), and may also provide more useful prognostic information. 4) In particular, serum cardiac troponin I (cTnI) levels are more sensitive than CK-MB levels for detection of minor ischemic myocardial injury in patients with small increases in total CK, and in addition may avoid the high incidence of false positives associated with the use of CK-MB as a diagnostic marker in perioperative MI.5) Some investigators have reported that cTnI is also useful in predicting the postoperative course after cardiac surgery, and that elevated serum cTnI levels are associated with increased in-hospital mortality.6,7) However, these reports included several different types of cardiac surgery...

show abstract

Higher Levels of Serum Cytokines and Myocardial Tissue Markers During On-Pump Versus Off-Pump Coronary Artery Bypass Surgery

Cited by 66 publications

References 20 publications

Off-pump surgery for the poor ventricle?

Off-pump surgery for the poor ventricle?

Off‐Pump Coronary Artery Bypass Grafting: 30 Years of Debate

Postoperative Cardiac Troponin I (cTnI) Level and Its Prognostic Value for Patients Undergoing Mitral Valve Surgery

Contact Info

Product

Resources

About