title: Which Mechanism is Effective on the Hyperamylasaemia After Coronary Artery Bypass Surgery?
abstract: OBJECTIVE
  Acute pancreatitis is one of the less frequently diagnosed lethal abdominal complications of cardiac surgery. The incidence of early postoperative period hyperamylasaemia was reported to be 30-70% of patients who underwent coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). The mechanism of pancreatic enzyme elevation after cardiac surgery is not clear. Our aim was to determine the relationship between ischaemia associated temporary renal dysfunction and elevation of pancreatic enzymes after CABG.
  
  
  METHODS
  Forty-one consecutive patients undergoing CABG under CPB were prospectively studied to determine serum total amylase, phospholipase A2, macroamylase, Cystatin C and urine NAG levels.
  
  
  RESULTS
  Hyperamylasaemia was observed in 88% of the cases, with a distribution of 6% at the beginning of cardioplegic arrest, 5% at the 20th minute after cardioplegic arrest, 7% at the 40th minute after cardioplegic arrest, 14% when the heart was re-started, 26% at the 6th hour of intensive care and 30% at the 24th hour of intensive care. All of these patients had asymptomatic isolated hyperamylasaemia, and none of them presented with clinical pancreatitis. As indicators of renal damage; Cystatin C and NAG levels were higher compared to baseline values.
  
  
  CONCLUSIONS
  Amylase began to rise during initial extracorporeal circulation and reached a maximum level postoperatively at 6 and 24hours. Decreased amylase excretion is the main reason for post CABG hyperamylasaemia.
authors.affiliation: Akut Kalp Damar Hospital, Department of Cardiovascular Surgery, İzmir, Turkey.
authors.forename: Halil Ibrahim
authors.initials: HI
authors.lastname: Algin
authors.affiliation: Akut Kalp Damar Hospital, Department of Cardiovascular Surgery, İzmir, Turkey. Electronic address: aliparlar20@gmail.com.
authors.forename: Ali Ihsan
authors.initials: AI
authors.lastname: Parlar
authors.affiliation: Dicle University Faculty of Medicine, Department of Medical Statistic, Diyarbakır, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Yildiz
authors.affiliation: Dokuz Eylül University Faculty of Medicine, Department of Biochemistry, İzmir, Turkey.
authors.forename: Zekiye Sultan
authors.initials: ZS
authors.lastname: Altun
authors.affiliation: Dokuz Eylül University Faculty of Medicine, Department of Biochemistry, İzmir, Turkey.
authors.forename: Gul Huray
authors.initials: GH
authors.lastname: Islekel
authors.affiliation: Akut Kalp Damar Hospital, Department of Cardiovascular Surgery, İzmir, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Uyar
authors.affiliation: Akut Kalp Damar Hospital, Department of Cardiovascular Surgery, İzmir, Turkey.
authors.forename: Engin
authors.initials: E
authors.lastname: Tulukoglu
authors.affiliation: Dokuz Eylül University Faculty of Medicine, Department of Cardiovascular Surgery, İzmir, Turkey.
authors.forename: Ozalp
authors.initials: O
authors.lastname: Karabay
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine*; D000368:Aged; D000681:Amylases / Q000097:blood*; D001026:Coronary Artery Bypass; D055316:Cystatin C / Q000097:blood*; D006801:Humans; D034321:Hyperamylasemia / Q000097:blood / Q000209:etiology / Q000652:urine; D008875:Middle Aged; D054467:Phospholipases A2 / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood / Q000652:urine
chemical_list: C525030:CST3 protein, human; D055316:Cystatin C; D054467:Phospholipases A2; D000681:Amylases; C001663:macroamylase; D000118:Acetylglucosaminidase
keywords: Amylase; Coronary artery bypass grafting; Cystatin C; Hyperamylasaemia; Lipase; Renal dysfunction