Regional Ischemic Preconditioning Enhances Myocardial Performance in Off-Pump Coronary Artery Bypass Grafting

Laurikka, Jari; Wu, Zhongkai; Iisalo, Pekka; Kaukinen, L.; Honkonen, Eva L.; Kaukinen, S.; Tarkka, Matti

doi:10.1378/chest.121.4.1183

Cited by 71 publications

(54 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients undergoing off-pump CABG but without collaterals may benefit from a number of measures such as ischemic myocardial preconditioning by short periods of repeated coronary occlusions, the use of intracoronary or aortocoronary shunting of blood, or a reduction of the coronary occlusion time by novel anastomosis techniques. [22][23][24][25][26] After preconditioning, less CK-MB release during PCI and less troponin release Kaplan-Meier estimates of proportion experiencing any event (composite of all-cause death, nonfatal stroke, nonfatal MI, and coronary reintervention) at 1 year after bypass surgery in patients with or without collaterals. Probability values were calculated with log-rank test.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Role of coronary collaterals in off-pump and on-pump coronary bypass surgery

Nathoe¹,

Buskens²,

Jansen³

2005

ACC Current Journal Review

View full text Add to dashboard Cite

Background-Collaterals limit infarct size, preserve viability, and reduce mortality in patients with acute myocardial infarction. In patients with stable coronary disease, collaterals are associated with less angina and ischemia during angioplasty and fewer ischemic events during follow-up. The role of collaterals has not been studied in patients undergoing off-pump or on-pump bypass surgery. Methods and Results-The population consisted of the 281 patients randomized to off-pump or on-pump CABG in the Octopus Study. Collaterals were defined on the baseline angiogram with the Rentrop score and were present in 49% and 51% of the patients in the off-pump and on-pump group, respectively. Perioperative myocardial infarction was defined by a creatine kinase-MB to CK ratio Ͼ10% and occurred in 18.2% in the off-pump group and 32.5% in the on-pump group. The unadjusted OR of perioperative myocardial infarction in the presence of collaterals was 0.31 (95% CI 0.17 to 0.84) in the off-pump group and 1.06 (95% CI 0.29 to 3.85) in the on-pump group After adjustment for age, gender, hypertension, hypercholesterolemia, diabetes, multivessel disease, ventricular dysfunction, incomplete revascularization, and ischemic time, the OR was 0.34 (95% CI 0.14 to 0.84) in the off-pump group and 1.28 (95% CI 0.30 to 5.40) in the on-pump group, respectively. Kaplan-Meier estimates of event-free survival at 1 year were 87% in patients with and 69% in those without collaterals after off-pump CABG. These estimates were 66% and 63%, respectively, after on-pump CABG. Conclusions-Collaterals protect against perioperative myocardial infarction during off-pump surgery but not during on-pump surgery and are associated with a better 1-year event-free survival.

show abstract

Section: Discussionmentioning

confidence: 99%

“…22,23 The safety of such novel surgical techniques has not been elucidated yet. Tissue formation due to endothelial damage at the site of the application may occur.…”

Section: Discussionmentioning

confidence: 99%

Role of coronary collaterals in off-pump and on-pump coronary bypass surgery

Nathoe¹,

Buskens²,

Jansen³

2005

ACC Current Journal Review

View full text Add to dashboard Cite

show abstract

“…Laurikka et al 25 applied the concept of IPC to 32 patients that were submitted to off-pump myocardial revascularization. These patients were randomized in two groups, with and without IPC.…”

Section: Discussionmentioning

confidence: 99%

O pré-condicionamento isquêmico influencia a contratilidade ventricular na cirurgia sem extracorpórea

Succi¹,

Gerola²,

Succi³

et al. 2010

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

show abstract

“…IPC has been defined as a process that increases tissue resistance to long-term ischemia via reperfusion periods following short ischemic episodes. [10] It is categorized in 2 groups: direct and remote IPC (RIPC). In direct IPC, the organ is subjected to short-term IR episodes before long-term ischemia.…”

Section: Introductionmentioning

confidence: 99%