title: Oxidative stress during coronary artery bypass operations: importance of surgical trauma and drug treatment.
abstract: 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.
authors.affiliation: Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Kirsti
authors.initials: K
authors.lastname: Berg
authors.forename: Rune
authors.initials: R
authors.lastname: Haaverstad
authors.forename: Rafael
authors.initials: R
authors.lastname: Astudillo
authors.forename: Mads
authors.initials: M
authors.lastname: Björngaard
authors.forename: Sissel
authors.initials: S
authors.lastname: Skarra
authors.forename: Rune
authors.initials: R
authors.lastname: Wiseth
authors.forename: Samar
authors.initials: S
authors.lastname: Basu
authors.forename: Per
authors.initials: P
authors.lastname: Jynge
mesh_terms: 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
chemical_list: D015415:Biomarkers; D020107:Troponin T; C075750:8-epi-prostaglandin F2alpha; D015237:Dinoprost