Minor myocardial damage and inflammatory response after three different procedures of left anterior descending artery revascularization.
BACKGROUND
Intracoronary stenting, conventional coronary artery bypass with cardiopulmonary bypass and minimally invasive direct coronary artery bypass without extracorporeal circulation are the three accepted options for revascularizing the left anterior descending coronary artery. We compare the effects of these three procedures in terms of minor myocardial damage and systemic inflammatory response.


METHODS
Ninety patients undergoing left anterior descending coronary artery revascularization with these three different techniques (thirty patients per group) were considered. Blood samples were collected preoperatively and immediately postoperatively, and then 24, 48 and 72 hours after the procedures to measure troponin I, creatine kinase, its MB fraction and C-reactive protein levels.


RESULTS
Postoperative levels of troponin I and MB-creatine kinase were significantly higher in conventional coronary grafting group than in PTCA-stent and in the minimally invasive surgery groups (p < 0.0003), while in both surgery groups there were higher post-operative levels of total creatine kinase and C-reactive protein (p = 0.0001).


CONCLUSIONS
Minimally invasive direct coronary artery bypass surgery and PTCA-stent are similar in terms of virtual absence of minor myocardial damage. Skeletal muscle damage and inflammatory reaction are comparable in surgical patients, but they do not appear to have any clinical relevance.
D000368:Aged; D000704:Analysis of Variance; D000787:Angina Pectoris / Q000097:blood / Q000150:complications / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000150:complications / Q000628:therapy; D004562:Electrocardiography; D005260:Female; D006335:Heart Injuries / Q000097:blood / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D009205:Myocarditis / Q000097:blood / Q000209:etiology*; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology*; D011446:Prospective Studies; D013997:Time Factors