Cardiac marker responses to coronary artery bypass graft surgery with cardiopulmonary bypass and aortic cross-clamping.
OBJECTIVE
To study several markers of myocardial injury in relation to aortic cross-clamping and cardiopulmonary bypass (CPB) after coronary artery bypass graft (CABG) surgery.


METHODS
Prospective observational study.


METHODS
University hospital.


METHODS
Thirty adult patients who underwent elective CABG surgery with aortic cross-clamping and CPB.


RESULTS
Serum levels of interleukin-6 (IL-6), interleukin-8 (IL-8), troponin-T (TnT), myosin light chain I (MLCI), and MB isoenzyme of creatine kinase (CK-MB), as markers of myocardial injury, were measured after induction of anesthesia for baseline values, then again at the end of surgery and on postoperative days 1, 3, and 5. IL-6, IL-8, and CK-MB levels were significantly elevated in the early postoperative stage. TnT significantly increased from the end of surgery to postoperative day 5. MLCI increased also but later than TnT. Aortic cross-clamping time correlated positively with peak TnT (r = 0.51, p < 0.05), TnT level on postoperative day 1 (r = 0.69, p < 0.01), and MLCI level on postoperative day 5 (r = 0.45, p < 0.05). CPB time was correlated only with peak TnT (r = 0.47, p < 0.05).


CONCLUSIONS
The increase in TnT level is strongly related to aortic cross-clamping.
Takeda
Shinhiro
S
Department of Anesthesiology and Intensive Care Medicine, Nippon Medical School, Tokyo, Japan. shinhiro@nms.ac.jp
Nakanishi
Kazuhiro
K
Ikezaki
Hiroyuki
H
Kim
Chol
C
Sakamoto
Atsuhiro
A
Tanaka
Keiji
K
Ogawa
Ryo
R
D000328:Adult; D000368:Aged; D001011:Aorta / Q000601:surgery*; D015415:Biomarkers / Q000097:blood*; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D003250:Constriction; D001026:Coronary Artery Bypass / Q000295:instrumentation*; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007527:Isoenzymes / Q000097:blood; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000601:surgery; D018994:Myosin Light Chains / Q000097:blood; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood
D015415:Biomarkers; D015850:Interleukin-6; D016209:Interleukin-8; D007527:Isoenzymes; D018994:Myosin Light Chains; D020107:Troponin T; C076659:myosin light chain I; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form