Reduced Expression of Systemic Proinflammatory Cytokines after Off-Pump versus Conventional Coronary Artery Bypass Grafting

Schulze, C.; Conrad, Nicole; Schütz, Albert J.; Egi, Koso; Reichenspurner, H.; Reichart, B.; Wildhirt, Stephen M.

doi:10.1055/s-2000-8352

Cited by 87 publications

(60 citation statements)

References 17 publications

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“…The activation of neutrophils constitutes a crucial step in inflammation, and leads to neutrophil sequestration within the tissues. Among the potential advantages of off-pump CABG surgery is that it allows for the attenuation of the systemic inflammatory response [17]. In another study, coronary revascularization with cardiopulmonary bypass (CPB) led to a significantly higher level of TNF-alpha, which was linked with P-selectin and ICAM-1 expression.…”

Section: Discussionmentioning

confidence: 95%

Could Red Cell Distribution Width Serve as a New Inflammatory Marker in Coronary Artery Bypass Grafting?

2014

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Aim. In our study, we researched whether on-pump and off-pump coronary artery bypass grafting (CABG) differ as regards their effect on postoperative red cell distribution width (RDW). Moreover, we also investigated whether there was a link between the preoperative and postoperative RDW levels and the early adverse events after CABG. Material and methods. In this study there were 127 consecutive patients who had previously undergone CABG. The patients were divided as group 1 (off-pump, n: 49) and group 2 (on-pump, n: 78). The hemogram and biochemistry panel values were measured a day before the operation, on the first, third and seventh days after it, and in the postoperative first and sixth months. Results. The statistically significant values detected in the hemogram were as follows: postoperative first day hemoglobin, postoperative first day leukocyte, postoperative first day thrombocyte, postoperative first day C-reactive protein, postoperative third day RDW, postoperative third day leukocyte, postoperative seventh day RDW, postoperative seventh day leukocyte, postoperative first month RDW, and postoperative first month thrombocyte (p<0,05). It was found in multivariate analysis that preoperative RDW is an independent risk factor for plasma used in the postoperative period (odds ratio: 0.552; 95% CI: 0.346-0.879; P=0.012). There was no link between preoperative RDW and other early adverse events in the postoperative period (p>0,05). Conclusion. We found that on-pump CABG increases the RDW levels more in the acute period, when compared with off-pump surgery, but that this effect disappears by the sixth month after the operation. For this reason, RDW can be used as a new inflammatory marker in patients undergoing CABG. Moreover, we observed that there was no clinical link between early adverse events after CABG and the pre-and postoperative RDW levels.Russ J Cardiol 2014, 7 (111), Engl.: 5-11

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Section: Discussionmentioning

confidence: 95%

Could Red Cell Distribution Width Serve as a New Inflammatory Marker in Coronary Artery Bypass Grafting?

2014

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“…Because inflammation also occurs in OPCAB surgery, be it less pronounced compared with on-pump CABG surgery, OPCAB patients remain at risk for a complicated postoperative course. [8][9][10] In this study in OPCAB patients, the authors failed to show an effect of aprotinin on the inflammatory mediators tested. It may be that the absence of contact activation in the OPCAB procedure makes the antiinflammatory action of aprotinin less pronounced.…”

Section: Discussionmentioning

confidence: 99%

“…Anesthesia induction was with midazolam (0.03 mg/kg), sufentanil (1-1.5 g/kg), propofol target-controlled infusion (starting target concentration of 0.5-1.0 g/mL), and pancuronium (0.1 mg/kg). Anesthesia maintenance was with a continuous propofol infusion (up to target concentration of 2.5 g/mL) and supplemental sufentanil (8)(9)(10) g/kg) and pancuronium. Vaporizers for volatile anesthetics were removed from the ventilator.…”

Section: Methodsmentioning

confidence: 99%

“…Although cardiopulmonary bypass (CPB) is a major factor eliciting a generalized inflammatory reaction, inflammation also occurs in off-pump cardiac surgery, be it in a less pronounced way. [8][9][10] Aprotinin has been demonstrated to reduce inflammation in CPB-supported cardiac surgery. [11][12][13][14][15][16][17][18][19] Whether aprotinin can further reduce inflammation in off-pump coronary artery bypass graft (OPCAB) surgery has currently not been investigated.…”

Section: B Oth Mechanical Injury During Cardiac Surgerymentioning

confidence: 99%

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Aprotinin Reduces Cardiac Troponin I Release and Inhibits Apoptosis of Polymorphonuclear Cells During Off-Pump Coronary Artery Bypass Surgery

Bert

Buck

Sergeant³

et al. 2008

Journal of Cardiothoracic and Vascular Anesthesia

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Objectives: In addition to blood-sparing effects, aprotinin may have cardioprotective and anti-inflammatory effects during cardiopulmonary bypass-assisted cardiac surgery. In this study, the authors examined whether aprotinin had cardioprotective and/or anti-inflammatory effects in patients undergoing off-pump coronary artery bypass grafting.Design: A prospective randomized clinical trial. Setting: University hospital. Participants: Fifty patients were randomized to control (n ‫؍‬ 25) or aprotinin treatment (n ‫؍‬ 25) groups.Interventions: Aprotinin was given as a loading dose (2 ؋ 10 6 KIU) followed by a continuous infusion at 5 ؋ 10 5 KIU/h until skin closure.Measurements and Main Results: Blood samples for cardiac troponin I; interleukin-6, interleukin-8, and interleukin-10; tumor necrosis factor ␣; and elastase were taken after anesthesia induction, completion of revascularization, and 6 hours, 12 hours, and 24 hours after revascularization. Blood samples were taken to assess for apoptosis in polymorphonuclear cells. Baseline plasma levels for cardiac troponin I did not differ between groups but were significantly lower in aprotinin-treated patients at the time of revascularization (p ‫؍‬ 0.03) and 6 hours (p ‫؍‬ 0.004) and 24 hours (p ‫؍‬ 0.03) later. Aprotinin significantly reduced apoptosis in polymorphonuclear cells compared with control-treated patients (p ‫؍‬ 0.04). There were no differences in plasma cytokine or elastase levels between groups.Conclusions: The authors conclude that aprotinin reduces perioperative cardiac troponin I release and attenuates apoptosis in polymorphonuclear cells but has no significant effects on plasma cytokine levels in patients undergoing off-pump coronary artery bypass graft surgery.

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“…CABG is conventionally performed with the use of cardiopulmonary bypass (CPB), which has been associated with an increased frequency of complications [1][2][3]. A variety of risk factors has been described to help delineate risk assessment of patients undergoing CABG, including preoperative left ventricular ejection fraction (LVEF) [4,5] and postoperative increase in creatine kinase myocardial band (CK-MB) levels [6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

The Cardioprotection of Silymarin in Coronary Artery Bypass Grafting Surgery

Altaei¹,

Jamal²,

Dilshad³

2013

Artery Bypass

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Reduced Expression of Systemic Proinflammatory Cytokines after Off-Pump versus Conventional Coronary Artery Bypass Grafting

Cited by 87 publications

References 17 publications

Could Red Cell Distribution Width Serve as a New Inflammatory Marker in Coronary Artery Bypass Grafting?

Could Red Cell Distribution Width Serve as a New Inflammatory Marker in Coronary Artery Bypass Grafting?

Aprotinin Reduces Cardiac Troponin I Release and Inhibits Apoptosis of Polymorphonuclear Cells During Off-Pump Coronary Artery Bypass Surgery

The Cardioprotection of Silymarin in Coronary Artery Bypass Grafting Surgery

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