Does off-pump coronary artery bypass surgery reduce secretion of plasminogen activator inhibitor-1?
Prior studies showed that postoperative increase in plasminogen activator inhibitor-1 (PAI-1) levels is associated with an increased risk of graft occlusion after coronary artery bypass surgery (CABG). This prospective study aimed to compare the changes of PAI-1 antigen levels after off-pump and on-pump CABG. Forty-four patients admitted for elective CABG were randomised to on-pump (n=22) or off-pump (n=22) surgery. Serum samples were collected for estimation of PAI-1 and tissue plasminogen activator (t-PA) antigen levels preoperatively and 2 h after the operation. The groups were similar in terms of age, weight, gender ratio and extent of coronary disease, left ventricular function and number of grafts per patient. Fibrinogen and t-PA levels increased postoperatively in both the groups when compared with baseline values. After operation, statistical analysis revealed that increase of PAI-1 values was higher in off-pump group (44.1+/-9.1 vs. 25.3+/-6.9) than on-pump group (37.2+/-5.5 vs. 27.3+/-7.8, p=0.002). This study shows that increase in PAI-1 antigen values in patients who undergo off-pump (beating heart) CABG is significantly higher than in those who undergo conventional CABG with cardiopulmonary bypass.
Ozkara
C
C
Department of Cardiovascular Surgery, Corlu Sifa Hospital, Tekirdag, and Department of Cardiology of Medical Faculty, Yuzuncu Yil University, Van, Turkey.
Guler
N
N
Batyraliev
T
T
Okut
H
H
Agirbasli
M
M
D001803:Blood Transfusion / Q000706:statistics & numerical data; D047549:Coronary Artery Bypass, Off-Pump; D003327:Coronary Disease / Q000097:blood / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism*; D011183:Postoperative Complications / Q000209:etiology; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies
D017395:Plasminogen Activator Inhibitor 1