title: Antioxidant status of patients after on-pump and off-pump coronary artery bypass grafting.
abstract: BACKGROUND
  It has been convincingly established that cardiopulmonary bypass routinely used in cardiac surgery induces an oxidative stress. The extensive production of reactive oxygen species occurring during cardiopulmonary bypass has a deleterious effect on the endogenous antioxidant defense pool. The recovery of antioxidant enzyme activities as well as other antioxidatively substances is one of the important tasks for the effective defense of patients in the postoperative period.
  
  
  OBJECTIVE
  Oxidative stress markers and the antioxidant status and the activities of some antioxidant enzymes were studied in patients during one-week period after cardiac revascularization performed using cardiopulmonary bypass and the results were compared with patients operated by off-pump technique.
  
  
  METHODS
  Thirty-nine patients undergoing elective surgical revascularization (coronary artery bypass grafting) were divided in two groups: twenty-two patients operated using cardiopulmonary bypass (group A) and a group B of seventeen patients undergoing pump-off surgery. Blood samples were drawn before operation and then in course of the first week after surgery. The following biochemical parameters were estimated: plasma levels of total antioxidant status (TAS) and of thiobarbituric acid reactive substances (TBARS) as well as erythrocyte activities of two antioxidant enzymes--superoxide dismutase (SOD) and glutathione peroxidase (GPx).
  
  
  RESULTS
  There was a significantly decreased preoperative and also postoperative levels of TAS associated with a preoperatively increased level of TBARS in group A only. In both groups of patients (especially in group B), markedly decreased activity of SOD was observed. The increase of GPx activity--especially on the third postoperative day--was not significant.
  
  
  CONCLUSIONS
  Regardless of the surgical technique, both groups of patients had a markedly decreased antioxidant capacity with a significantly increased production of lipid peroxides especially in patients operated with cardiopulmonary bypass. The decreased antioxidant status was connected with decreased erythrocyte activity of SOD. Therefore, we recommend the regular supply of antioxidant acting substances (antioxidant vitamins and coenzyme Q10) be included in their standard therapeutic strategy especially in the preoperative period. (Tab. 2, Fig. 4, Ref: 22.)
authors.affiliation: Slovak Institute of Cardiovascular Diseases, Bratislava, Slovakia. pechan@susch.sk
authors.forename: I
authors.initials: I
authors.lastname: Pechan
authors.forename: I
authors.initials: I
authors.lastname: Olejarova
authors.forename: K
authors.initials: K
authors.lastname: Danova
authors.forename: V
authors.initials: V
authors.lastname: Fischer
authors.forename: H
authors.initials: H
authors.lastname: Minarova
authors.forename: A
authors.initials: A
authors.lastname: Dobisova
authors.forename: L
authors.initials: L
authors.lastname: Halcak
authors.forename: V
authors.initials: V
authors.lastname: Rendekova
authors.forename: I
authors.initials: I
authors.lastname: Gabauer
mesh_terms: D000975:Antioxidants / Q000032:analysis*; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D005260:Female; D005979:Glutathione Peroxidase / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D013482:Superoxide Dismutase / Q000097:blood; D017392:Thiobarbituric Acid Reactive Substances / Q000032:analysis
chemical_list: D000975:Antioxidants; D017392:Thiobarbituric Acid Reactive Substances; D005979:Glutathione Peroxidase; D013482:Superoxide Dismutase