title: Perioperative enoximone infusion improves cardiac enzyme release after CABG.
abstract: OBJECTIVE
  To assess whether routine postoperative enoximone infusion compared with dobutamine improved clinical and biochemical results after coronary artery bypass grafting with cardiopulmonary bypass.
  
  
  METHODS
  Prospective nonrandomized study. Data collection was blinded to the choice of inotrope.
  
  
  METHODS
  Double-institutional clinical investigation.
  
  
  METHODS
  Two hundred sixteen consecutive patients undergoing myocardial revascularization between May 2000 and December 2002.
  
  
  METHODS
  Seventy-two patients underwent myocardial revascularization and were treated with enoximone, 5 microg/kg/min (group A). They were compared in a ratio of 1:2 to 144 patients treated with dobutamine at the same dose (group B) after aortic cross-clamp removal. The groups proved to be homogenous in preoperative and intraoperative characteristics.
  
  
  RESULTS
  Hospital outcome, electrocardiogram, echocardiography, further inotropic support, and biochemical markers of ischemia were compared. Subsets of patients with comorbidities and total arterial revascularization were analyzed. Perioperative myocardial infarction, postoperative low-output syndrome, intra-aortic balloon pump, atrial fibrillation, ST-segment changes, postoperative echocardiographic findings, and intensive care and hospital durations were similar between groups. In the postoperative course, more patients belonging to group A maintained low-dose inotropic support, whereas more patients belonging to group B required higher doses. Troponin I and creatine kinase-MB values were higher in patients of group B, especially when subgroups with diabetes, left ventricular hypertrophy, or total arterial revascularization were included.
  
  
  CONCLUSIONS
  Postoperative enoximone reduced troponin I release and need for inotropic support in patients undergoing on-pump myocardial revascularization. Subgroup data were confirmed in diabetes, left ventricular hypertrophy, and total arterial revascularization.
authors.affiliation: Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Italy. frankono@libero.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Onorati
authors.forename: Attilio
authors.initials: A
authors.lastname: Renzulli
authors.forename: Marisa
authors.initials: M
authors.lastname: De Feo
authors.forename: Nicola
authors.initials: N
authors.lastname: Galdieri
authors.forename: Pasquale
authors.initials: P
authors.lastname: Santè
authors.forename: Pasquale
authors.initials: P
authors.lastname: Mastroroberto
authors.forename: Massimo
authors.initials: M
authors.lastname: Bilotta
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cotrufo
mesh_terms: D002315:Cardiopulmonary Bypass; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D001026:Coronary Artery Bypass; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form; D004280:Dobutamine / Q000008:administration & dosage; D004562:Electrocardiography; D017335:Enoximone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007527:Isoenzymes / Q000097:blood; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000201:enzymology*; D011182:Postoperative Care; D011183:Postoperative Complications; D019210:Troponin I / Q000097:blood
chemical_list: D002316:Cardiotonic Agents; D007527:Isoenzymes; D019210:Troponin I; D004280:Dobutamine; D017335:Enoximone; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form