title: Inflammatory response after coronary revascularization: off-pump versus on-pump (heparin-coated circuits and poly2methoxyethylacrylate-coated circuits).
abstract: OBJECTIVE
  Off-pump coronary artery bypass grafting (OPCAB) may reduce the inflammatory response associated with cardiopulmonary bypass (CPB) and contribute to minimizing postoperative complications. Heparin-coated circuits and poly2methoxyethylacrylate (PMEA)-coated circuits were developed to reduce such complications. We compared the postoperative inflammatory response with or without CPB.
  
  
  METHODS
  Eighteen consecutive patients undergoing isolated coronary artery bypass grafting (CABG) were divided into three groups: OPCAB group (n=6), heparin-coated circuits group (n=6), PMEA-coated circuits group (n=6). The plasma concentrations of the following inflammatory markers were measured: cytokines [interleukin (IL-10)], polymorphonuclear elastase (PMNE), coagulofibrinolytic factor [thrombin-antithrombin III complex (TAT)], complement factor (C3a).
  
  
  RESULTS
  At the end of CPB, IL-10 and TAT concentrations were significantly different among the three groups (OPCAB group < PMEA-coated group < heparin-coated group). The PMNE concentration was significantly lower in the OPCAB group and the heparin-coated group as compared to the PMEA-coated group both at the end of CPB and 4 hours after CPB. C3a concentration was significantly lower in the OPCAB group than in the CPB groups at the end of CPB. Clinical variables did not differ significantly among the three groups.
  
  
  CONCLUSIONS
  Off-pump CABG is associated with a reduction in the inflammatory response when compared with on-pump CABG, using either PMEA-coated or heparin-coated circuits.
authors.affiliation: Department of Cardiovascular Surgery, Nagasaki University School of Medicine, Nagasaki, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Hazama
authors.forename: Kiyoyuki
authors.initials: K
authors.lastname: Eishi
authors.forename: Shiro
authors.initials: S
authors.lastname: Yamachika
authors.forename: Manabu
authors.initials: M
authors.lastname: Noguchi
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Ariyoshi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Takai
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Odate
authors.forename: Seiji
authors.initials: S
authors.lastname: Matsukuma
authors.forename: Daisuke
authors.initials: D
authors.lastname: Onohara
authors.forename: Makoto
authors.initials: M
authors.lastname: Yanatori
mesh_terms: D000179:Acrylates / Q000494:pharmacology; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000494:pharmacology; D001672:Biocompatible Materials / Q000494:pharmacology; D015415:Biomarkers; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000295:instrumentation*; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D006493:Heparin / Q000494:pharmacology; D006801:Humans; D007107:Immune System / Q000187:drug effects; D007249:Inflammation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011108:Polymers / Q000494:pharmacology; D016896:Treatment Outcome
chemical_list: D000179:Acrylates; D000925:Anticoagulants; D001672:Biocompatible Materials; D015415:Biomarkers; D011108:Polymers; C413485:poly(2-methoxyethylacrylate); D006493:Heparin