Malondialdehyde in plasma, a biomarker of global oxidative stress during mini-CABG compared to on- and off-pump CABG surgery: a pilot study

Gerritsen, Wim B.; Gründeman, Paul F.; Boss, David S.; Haas, Fred J. L. M.; Dongen, Eric P. van; Aarts, Leon

doi:10.1510/icvts.2005.116061

Cited by 33 publications

(36 citation statements)

References 13 publications

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“…6,16 In the control group, there was a statistically very significant (p<0.001) increase in MDA levels but in the study group there was a non-significant decrease. Thus in the postoperative period, the MDA levels were significantly higher in the control group (p=0.033), implying an attenuated oxidative injury in the NAC treated group.…”

Section: Discussionmentioning

confidence: 91%

“…2,3,14,15 Postoperative pulmonary dysfunction has been attributed to widespread systemic inflammatory response, as a result of oxidative stress, 4 which results from an imbalance between local antioxidant defenses and formation of reactive oxygen derived free radicals. ROS are highly reactive and, when generated close to cell membranes, can induce lipid peroxidation (Oxidation of membrane phospholipids) and the accumulation of their products including MDA, 16,10,17 4-hydroxy-2-nonenal, acrolein, hydroperoxides, 5 and F2-isoprostanes. 6,7,9 Elevated levels of these products acts as an indirect measure of free radical activity.…”

Section: Discussionmentioning

confidence: 99%

“…18 To prevent elevations in proinflammatory cytokines and complement activation during cardiac surgery, several agents viz. Steroids, 23 aprotinin, 16 pentoxiphylline, 24 N-acetylcysteine were tried for their beneficial role.…”

Section: Discussionmentioning

confidence: 99%

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Effect of N - Acetylcysteine on Pulmonary Function in Patients Undergoing Off Pump Coronary Artery Bypass Grafting

Jalakandan¹,

Bhaskaran²

2015

jemds

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OBJECTIVE:Postoperative lung injury is one of the most frequent complications of cardiac surgery. Increasingly used Off Pump Coronary Artery Bypass Grafting (OPCABG) has significantly reduced the oxidative stress and the inflammatory response associated with the use of cardiopulmonary bypass (CPB). However, OPCABG is also associated with significant oxidative stress and its related complications. The present study is a prospective, randomized, double blind investigating the effects of N-acetylcysteine (NAC), a potent anti-oxidant on pulmonary functions in patients undergoing OPCABG. METHODS: Fifty patients undergoing elective OPCABG were randomized into two groups. Group A (n=25), the control group received 200ml of Normal saline immediately following induction whereas Group B (n=25), the study group received 150mg/kg of NAC in 200ml of Normal saline at the same time. Pulmonary Capillary Wedge Pressure (PCWP), Pulmonary Artery Pressure (PAP), Dynamic lung compliance (C Dyn), Static lung compliance (C Stat), Alveolar -arterial oxygen gradient (A-a Do2) were measured immediately following induction, after admission into ICU, and then 4 th hourly till extubation. Malondialdehyde (MDA) and Glutathione (GSH) levels were assayed once immediately following induction and again immediately after shifting to ICU. RESULTS: Demographic profile, pre-incision clinical and biochemical values were comparable in both the groups. PCWP, PAP-Diastole were lower and C Dyn and C Stat were significantly higher in study group when compared to control group. No difference in PAP-Systole was found. Both the groups had increased A-a Do2, but the increase was significantly lower in the study group. At the end of surgery, MDA levels were significantly raised in control group (p<0.001) whereas its levels were maintained in study group (p<0.569). GSH levels were significantly decreased in control group (p<0.001) whereas its levels were significantly increased in study group (p<0.001). CONCLUSION: OPCABG was associated with significant oxidative response but the administration of NAC attenuates this stress response by replenishing the GSH stores. NAC improves pulmonary function in terms of increased compliance and increased systemic oxygenation.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of N - Acetylcysteine on Pulmonary Function in Patients Undergoing Off Pump Coronary Artery Bypass Grafting

Jalakandan¹,

Bhaskaran²

2015

jemds

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“…The produced ROS during oxidative stress will result in proteins oxidation, peroxidation of lipids, and nitric oxide (NO) inactivation, leading to endothelial damage and micro-vascular dysfunction [14,15]. This may delay post CABG recovery of cardiac function.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Serum Myocardial Biomarkers Following Two Different Methods of Venoaortic Connection in Coronary Artery Bypass Grafting: A Randomized Clinical Trial

Jelodar

Zarrabi

Nazifi

et al. 2017

Zahedan J Res Med Sci

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Background: Myocardium will expose to excessive ischemia and reperfusion during post-cardiac surgery, hence the aim of this study was to investigate the cardioprotective effect of sequential partial aortic side biting technique for proximal veno-aortic anastomosis constructions in patients undergoing coronary artery bypass grafting (CABG). Methods: In this randomized clinical trial study, 60 consecutive patients who were diagnosed to suffering from triple vessel coronary artery diseases were selected. CABG patients were assigned randomly into two groups; the first group received sooner and gradual myocardial reperfusion one-by-one top end venous anastomosis to the aorta (sequential aortic side biting technique) (n = 30) and the second group undergo proximal anastomoses constructed during a single period of aortic side biting (single aortic side biting technique) (n = 30). The serum levels of myocardial damage biomarkers including creatine phosphokinase-MB (CPK-MB), Troponin I, glutathione peroxidase (GPX), superoxide dismutase (SOD), malondialdehyde (MDA) and catalase (CAT) were measured preoperatively, postoperatively and 24 h after operation. Independent t-tests was used to compare results between groups. Results: The level of all myocardial biomarkers increased after the operation. Those in study group had significantly lower levels of troponin I (P < 0.001), CPK-MB (P = 0.001), GPX (P = 0.007), SOD (P = 0.005), and CAT (P = 0.015), 24h after the operation when compared to control group. Only the serum level of CPK-MB was significantly lower in study group after the operation (P = 0.029) while the other markers were comparable. Conclusions: Sequential partial occluding aortic side biting technique associated with less myocardial damage and ischemiareperfusion injury compared to conventional single method in patients undergoing elective coronary grafting.

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“…Conventional on-pump bypass surgery is associated with a systemic inflammatory response and an increased production of reactive oxygen species due to ischemia-reperfusion injury [7]. Furthermore, the use of cardioplegic arrest can also result in myocardial dysfunction resulting in hypoperfusion [8].…”

Section: Discussionmentioning

confidence: 99%

Malondialdehyde kinetics following coronary artery bypass grafting and its relation to osteopontin

et al. 2014

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Background Cardiac surgery is associated with inflammation and oxidative stress; malondialdehyde (MDA) is a marker of oxidative stress and osteopontin (OPN) is a proinflammatory cytokine. We studied MDA kinetics following coronary artery bypass grafting (CABG) and its relation to OPN.Methods We evaluated 50 consecutive patients (60 ± 10 year-old, 44 men and 6 women) with stable coronary artery disease and left ventricular ejection fraction of 50 ± 8 % undergoing elective CABG on pump. Peripheral plasma samples were drawn at baseline, 24 and 72 h postoperatively. OPN was evaluated at baseline and MDA and cardiac enzymes at all time points.Results MDA levels increased significantly at 72 h postoperative compared with preoperative and 24 h postoperative levels whereas there was no difference between the pre and first postoperative values (p = 0.67). MDA change was positively correlated with the change in troponin at baseline and at 72 h (r = 0.6, p = 0.022) as well as with preoperative OPN levels (r = 0.28, p = 0.047). There was a significant positive correlation between MDA at 72 h and age (r = 0.27, p = 0.039). In addition, MDA change differed significantly in relation to diabetes at baseline and at 72 h-2.99 (4.77) in diabetics versus 0.69 (3.82) in non-diabetics (p = 0.05).Conclusions MDA increases post on-pump CABG but only at 72 h and this increase correlates with preoperative OPN levels. In addition, MDA increase is related to age and diabetes as well as troponin increase following surgery.

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Malondialdehyde in plasma, a biomarker of global oxidative stress during mini-CABG compared to on- and off-pump CABG surgery: a pilot study

Cited by 33 publications

References 13 publications

Effect of N - Acetylcysteine on Pulmonary Function in Patients Undergoing Off Pump Coronary Artery Bypass Grafting

Effect of N - Acetylcysteine on Pulmonary Function in Patients Undergoing Off Pump Coronary Artery Bypass Grafting

Comparison of Serum Myocardial Biomarkers Following Two Different Methods of Venoaortic Connection in Coronary Artery Bypass Grafting: A Randomized Clinical Trial

Malondialdehyde kinetics following coronary artery bypass grafting and its relation to osteopontin

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