Cardiac marker responses to coronary artery bypass graft surgery with cardiopulmonary bypass and aortic cross-clamping.

摘要

OBJECTIVE: To study several markers of myocardial injury in relation to aortic cross-clamping and cardiopulmonary bypass (CPB) after coronary artery bypass graft (CABG) surgery. DESIGN: Prospective observational study. SETTING: University hospital. PARTICIPANTS: Thirty adult patients who underwent elective CABG surgery with aortic cross-clamping and CPB. Measurements and Main Results: Serum levels of interleukin-6 (IL-6), interleukin-8 (IL-8), troponin-T (TnT), myosin light chain I (MLCI), and MB isoenzyme of creatine kinase (CK-MB), as markers of myocardial injury, were measured after induction of anesthesia for baseline values, then again at the end of surgery and on postoperative days 1, 3, and 5. IL-6, IL-8, and CK-MB levels were significantly elevated in the early postoperative stage. TnT significantly increased from the end of surgery to postoperative day 5. MLCI increased also but later than TnT. Aortic cross-clamping time correlated positively with peak TnT (r = 0.51, p < 0.05), TnT level on postoperative day 1 (r = 0.69, p < 0.01), and MLCI level on postoperative day 5 (r = 0.45, p < 0.05). CPB time was correlated only with peak TnT (r = 0.47, p < 0.05). CONCLUSIONS: The increase in TnT level is strongly related to aortic cross-clamping.