Oxidative stress during coronary artery bypass operations: importance of surgical trauma and drug treatment.
OBJECTIVE
To investigate oxidative stress and myocardial injury at different stages of coronary artery bypass grafting (CABG).


METHODS
Twenty patients underwent CABG with use of cardiopulmonary bypass (CPB) and with intermittent sampling of plasma and urine. Main markers were: 8-iso-PGF2alpha (oxidative stress); troponin T (myocardial injury); and 15-keto-dihydro-PGF2alpha and hsCRP (inflammation).


RESULTS
Plasma 8-iso-PGF2alpha increased after start of surgery, but there was no further rise during CPB or after aortic cross-clamp release and no significant myocardial arterio-venous differences. An increase in troponin T was seen early after the operation, but no relationship was established between 8-iso-PGF2alpha and troponin T. 8-iso-PGF2alpha levels were elevated by preoperative withdrawal of acetylsalicylic acid (ASA) but reduced by intraoperative use of heparin. 15-keto-dihydro-PGF2alpha was elevated during operation and hsCRP following operation.


CONCLUSIONS
In the present study oxidative stress was multifactorial in origin with main impacts from surgical trauma, less from CPB and little if any from myocardial ischemia-reperfusion events. In addition, cardiovascular drugs in common use like ASA and heparin seemed to influence the pro- and antioxidant balance, a finding that has to be confirmed in future studies.
Berg
Kirsti
K
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
Haaverstad
Rune
R
Astudillo
Rafael
R
Björngaard
Mads
M
Skarra
Sissel
S
Wiseth
Rune
R
Basu
Samar
S
Jynge
Per
P
D000368:Aged; D015415:Biomarkers; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods*; D015237:Dinoprost / Q000031:analogs & derivatives / Q000032:analysis; D004358:Drug Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015425:Myocardial Reperfusion; D018384:Oxidative Stress / Q000187:drug effects; D020107:Troponin T / Q000032:analysis
D015415:Biomarkers; D020107:Troponin T; C075750:8-epi-prostaglandin F2alpha; D015237:Dinoprost