Research proposal: inflammation and oxidative stress in coronary artery bypass surgery graft: comparison between diabetic and non-diabetic patients

Silva, Ana Catarina Romano e; Dias, Glauber Monteiro; Carvalho, Jorge José de; Lorenzo, Andrea De; Kasal, Daniel A.

doi:10.1186/s13104-018-3743-5

Cited by 5 publications

(2 citation statements)

References 25 publications

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“…Cardiac surgery, particularly coronary bypass graft surgery (CABG), in patients with coronary artery disease (CAD) improves the quality of life, reduces the severity of myocardial ischemia and, in some patients, prolongs life [1,2]. Intraoperative and postoperative periods are accompanied by hemodynamic overload for the myocardium, as they lead to an increase in inflammation and oxidative stress, hemostatic disorders, electrolyte imbalance and fluid overload [3]. Therefore, searching for methods to reduce the risk of early and late postoperative complications in this group of patients remains necessary.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Analysis of Factors Associated with New Episode of Postoperative Atrial Fibrillation after Coronary Artery Bypass Graft Surgery

Rubanenko,

Davydkin

2023

Life

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The aim of the study was to perform a comprehensive fundamental analysis of the factors of inflammation, oxidative stress, fibrosis, myocardial dysfunction, ischemia and omega-3 index associated with postoperative atrial fibrillation (POAF) after coronary artery bypass graft (CABG) surgery in patients with coronary artery disease. The study involved 158 patients who were admitted to the hospital to undergo CABG surgery. Patients were divided into two groups: group 1 comprised 111 patients without POAF (82% males, median age—62.0 (56.0; 66.0) years), and group 2 comprised 47 patients with POAF (84.4% males, median age—65.0 (61.0; 70.0) years). POAF occurred 5.2 (2.0; 7.0) days after CABG. In all the patients, we evaluated laboratory tests before and 3–4 days after CABG. All the patients also underwent echocardiography. According to results of multifactorial regression analysis, the odds ratio of POAF development for left atrial diameter >41 mm was 4.3 (95% confidence interval (CI) 2.0–9.7, p < 0.001), interleukin (IL)-6 postoperative levels >22.07 pg/mL—3.0 (95% CI 1.4–8.2, p = 0.006), IL-8 postoperative levels >9.67 pg/mL—2.3 (95% CI 1.2–7.3, p = 0.006), superoxide dismutase postoperative levels in plasma >1100.5 U/g—3.2 (95% CI 1.4–9.2, p = 0.03), glutathione postoperative levels ≤0.194 micromole/g of hemoglobin—1.9 (95% CI 1.2–6.3, p < 0.001), glutathione peroxidase postoperative levels ≤17.36 millimole/g of hemoglobin—2.2 (95% CI 1.1–8.2, p < 0.001), glutathione reductase postoperative levels ≤2.99 millimole/g of hemoglobin—2.3 (95% CI, 1.1–5.7, p < 0.001), malondialdehyde postoperative levels >1.25 micromole/g of hemoglobin—2.0 (95% CI, 1.2–7.9, p < 0.001), NO postoperative levels in plasma >36.4 micromole/L—1.5 (95% CI, 1.1–5.9, p < 0.001) and omega-3 index ≤1.59%—2.6 (95% CI 1.5–9.1, p < 0.001). Our study showed that increased left atrial diameter, high postoperative levels of inflammatory factors, oxidative stress, fibrosis indicators and omega-3 index were associated with POAF in patients who underwent CABG.

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Section: Introductionmentioning

confidence: 99%

Comprehensive Analysis of Factors Associated with New Episode of Postoperative Atrial Fibrillation after Coronary Artery Bypass Graft Surgery

Rubanenko,

Davydkin

2023

Life

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“…HbA1c have significant role in inducing dyslipidaemia, hyperhomocysteinemia, hypertension and increasing C-reactive protein, oxidative stress, and blood viscosity 56 . Cardiac surgery, stress, and anaesthesia can exacerbate oxidative stress and increase blood viscosity, thereby perpetuating the effect of high HbA1c in patients with diabetes and likelihood of devolvement of cardiovascular event 57 . Increased blood viscosity of diabetic patients, leading to blood clots, which can precipitate acute MI 58 .…”

Section: Discussionmentioning

confidence: 99%

Glycated Hb levels and its effect on outcomes in Cardiac Surgery

et al.

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There remains a significant paucity of information evaluating the effect of glycated HbA1c levels and its theorized effect on mortality and morbidity rates following cardiac surgery. Diabetes is a very common comorbidity in patients undergoing open heart surgery as there is shift in patient characteristics and being higher risk. Currently, the evidences are controversial and there is no clear consensus that increased HbA1c levels is associated with an increased perioperative mortality rate. However, reported literature are more commonly able to demonstrate elevated HbA1c levels to be associated with increased rates of wound infection, cardiovascular events and renal failure; thus, higher morbidities postoperatively. This literature review aims to examine the evidence synthesis behind each of morbidities and mortalities associated with open heart surgery and the impact of high HbA1c on the reported outcomes.

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Effects of Preoperative HbA1c Levels on the Postoperative Outcomes of Coronary Artery Disease Surgical Treatment in Patients with Diabetes Mellitus and Nondiabetic Patients: A Systematic Review and Meta-Analysis

Wang

Luo

Jin

et al. 2020

Journal of Diabetes Research

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Aims. To investigate the effect of preoperative HbA1c levels on the postoperative outcomes of coronary artery disease surgery in diabetic and nondiabetic patients. Methods and Results. The MEDLINE (via PubMed), Cochrane Library, Web of Science, Embase, Wanfang Data, China National Knowledge Infrastructure (CNKI), and Chinese Biology Medicine (CBM) databases were used to search the effects of different preoperative HbA1c levels on the postoperative outcomes of coronary artery disease surgical treatment in diabetic and nondiabetic patients from inception to December 2018. Two review authors worked in an independent and duplicate manner to select eligible studies, extract data, and assess the risk of bias of the included studies. We used a meta-analysis to synthesize data and analyze subgroups, sensitivity, and publication bias as well as the GRADE methodology if appropriate. The literature search retrieved 886 records initially, and 23 cohort studies were included in the meta-analysis. In this meta-analysis, we found that there was a reduced incidence of surgical site infections (OR=2.94, 95% CI 2.18-3.98), renal failure events (OR=1.63, 95% CI 1.13-2.33), and myocardial infarction events (OR=1.69, 95% CI 1.16-2.47), as well as a shortened hospital stay (MD=1.08, 95% CI 0.46-1.71), in diabetic patients after coronary artery disease surgical treatment with lower preoperative HbA1c levels. For nondiabetic patients, a higher preoperative HbA1c level resulted in an increase in the incidence of mortality (OR=2.23, 95% CI 1.01-4.90) and renal failure (OR=2.33, 95% CI 1.32-4.12). No significant difference was found between higher and lower preoperative HbA1c levels in the incidence of mortality (OR=1.06, 95% CI 0.88-1.26), stroke (OR=1.49, 95% CI 0.94-2.37), or atrial fibrillation (OR=0.94, 95% CI 0.67-1.33); the length of ICU stay (MD=0.20, 95% CI -0.14-0.55); or sepsis incidence (OR=2.49, 95% CI 0.99-6.25) for diabetic patients or for myocardial infarction events (OR=1.32, 95% CI 0.27-6.31) or atrial fibrillation events (OR=0.99, 95% CI 0.74-1.33) for nondiabetic patients. The certainty of evidence was judged to be moderate or low. Conclusion. This meta-analysis showed that higher preoperative HbA1c levels may potentially increase the risk of surgical site infections, renal failure, and myocardial infarction and reduce the length of hospital stay in diabetic subjects after coronary artery disease surgical treatment and increase the risk of mortality and renal failure in nondiabetic patients. However, there was great inconsistency in defining higher preoperative HbA1c levels in the studies included; we still need high-quality RCTs with a sufficiently large sample size to further investigate this issue in the future. This trial is registered with CRD42019121531.

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Research proposal: inflammation and oxidative stress in coronary artery bypass surgery graft: comparison between diabetic and non-diabetic patients

Cited by 5 publications

References 25 publications

Comprehensive Analysis of Factors Associated with New Episode of Postoperative Atrial Fibrillation after Coronary Artery Bypass Graft Surgery

Comprehensive Analysis of Factors Associated with New Episode of Postoperative Atrial Fibrillation after Coronary Artery Bypass Graft Surgery

Glycated Hb levels and its effect on outcomes in Cardiac Surgery

Effects of Preoperative HbA1c Levels on the Postoperative Outcomes of Coronary Artery Disease Surgical Treatment in Patients with Diabetes Mellitus and Nondiabetic Patients: A Systematic Review and Meta-Analysis

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