title: Release of brain natriuretic-related peptides (BNP, NT-proBNP) and cardiac troponins (cTnT, cTnI) in on-pump and off-pump coronary artery bypass surgery.
abstract: BACKGROUND
  We studied the kinetic release of cardiac troponins (cTnI and cTnT) and B-type natriuretic peptides (BNP and NT-proBNP) in patients undergoing off-pump or on-pump coronary artery bypass surgery.
  
  
  METHODS
  Twenty-five consecutive patients were prospectively enrolled. The patients were divided into three groups: beating heart (I), and cardiopulmonary bypass (CPB) with warm (II) or cold cardioplegia (III). Plasma samples were obtained before anesthesia induction until the sixth day after surgery.
  
  
  CONCLUSIONS
  The data were analyzed first for off-pump versus the CPB procedures and second for warm versus cold cardioplegia. The plasma troponin releases appeared to be significantly higher in the CPB groups in comparison to the beating heart group (P < 0.001 and P < 0.002 for cTnI and cTnT peak values, respectively). The peak of the B-type natriuretic peptide release appeared to be more delayed in the groups undergoing CPB than in the beating heart group (day 6 versus days 2 and 4 for NT-proBNP and BNP, respectively). Taken together, our results indicated that the new generation of cTnT assays seemed to be more sensitive than the cTnI assays for the diagnosis of myocardium injury. A lower increase in the cTnT values in the warm cardioplegic group indicated less damage of the myocardium than with cold cardioplegia. Our data also confirm better preservation of the myocardium with off-pump cardiac surgery than with CPB.
authors.affiliation: Department of Cardiothoracic Surgery, CHU Pitié-Salpêtrière, Pitié-Salpêtrière Hospital, AP-HP, 47-83 Boulevard de l'Hôpital, 75651 Paris, Cedex 13, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Guerin
authors.forename: Said Ben
authors.initials: SB
authors.lastname: Ayed
authors.forename: Shaida
authors.initials: S
authors.lastname: Varnous
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Golmard
authors.forename: Pascal
authors.initials: P
authors.lastname: Leprince
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Beaudeux
authors.forename: Iradj
authors.initials: I
authors.lastname: Gandjbakhch
authors.forename: Maguy
authors.initials: M
authors.lastname: Bernard
mesh_terms: D015415:Biomarkers; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D050792:Circulatory Arrest, Deep Hypothermia Induced; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000096:biosynthesis*; D011379:Prognosis; D011446:Prospective Studies; D013318:Stroke Volume; D019210:Troponin I / Q000096:biosynthesis*; D020107:Troponin T / Q000096:biosynthesis*
chemical_list: D015415:Biomarkers; D019210:Troponin I; D020107:Troponin T; D020097:Natriuretic Peptide, Brain