Quantification of myocardial injury during coronary artery bypass graft.
Serial intraoperative myocardial-specific creatine-kinase (MB-CK) samples were obtained in 32 patients undergoing coronary artery bypass graft (CABG). Based upon their postoperative ECG and technetium pyrophosphate SCAN results, each patient was classified as either Group A (MI), B (normal), or C (equivocal). Peak MB-CK was reported for each group. The mean value for Group A (75 +/- 17 IU/L) is higher than for Group B (18 +/- 1 IU/L) or Group C (30 +/- IU/L). The concept of measuring and a formula for calculation of intraoperative myocardial injury are presented. The mean value for Group A (MI, 10,709 +/- 5885) is higher than either groups B (normal) or C (equivocal) by a test of proportionality (P < 0.001). Likewise, Group C (898 +/- 159) is higher than B (466 +/- 71) (P < 0.05). This index, while in need of further validation, corresponds closely to the clinical status of the 32 patients studied and should provide a means more refined than mortality or incidence of MI upon which to judge efficacy of any proposed means of operative myocardial preservation.
Gray
R J
RJ
Department of Cardiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, California 90048, USA.
Shell
W E
WE
Conklin
C
C
Ganz
W
W
Shah
P K
PK
Miyamoto
A T
AT
Matloff
J M
JM
Swan
H J
HJ
D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003327:Coronary Disease / Q000601:surgery*; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009206:Myocardium / Q000473:pathology*
D007527:Isoenzymes; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form