Open AccessComparison of Serum Myocardial Biomarkers Following Two Different Methods of Venoaortic Connection in Coronary Artery Bypass Grafting: A Randomized Clinical Trial
Author(s) -
Gholamali Jelodar,
Khalil Zarrabi,
Saeed Nazifi,
Azimeh Azimifar
Publication year - 2017
Publication title -
majallah-i taḥqīqāt-i ̒ulūm-i pizishkī-i zāhidān/majallah-i taḥqīqāt-i ̒ulūm-i pizishkī-i zāhidān./zahedan journal of researches in medical sciences
Language(s) - English
Resource type - Journals
eISSN - 2228-6403
pISSN - 2008-7977
DOI - 10.5812/zjrms.10740
Subject(s) - medicine , cardiology , aorta , anastomosis , troponin i , malondialdehyde , artery , creatine kinase , cardiac surgery , surgery , myocardial infarction , oxidative stress
BackgroundMyocardium will expose to excessive ischemia and reperfusion during post-cardiac surgery, hence the aim of this study was to investigate the cardioprotective effect of sequential partial aortic side biting technique for proximal veno-aortic anastomosis constructions in patients undergoing coronary artery bypass grafting (CABG).MethodsIn this randomized clinical trial study, 60 consecutive patients who were diagnosed to suffering from triple vessel coronary artery diseases were selected. CABG patients were assigned randomly into two groups; the first group received sooner and gradual myocardial reperfusion one-by-one top end venous anastomosis to the aorta (sequential aortic side biting technique) (n = 30) and the second group undergo proximal anastomoses constructed during a single period of aortic side biting (single aortic side biting technique) (n = 30). The serum levels of myocardial damage biomarkers including creatine phosphokinase-MB (CPK-MB), Troponin I, glutathione peroxidase (GPX), superoxide dismutase (SOD), malondialdehyde (MDA) and catalase (CAT) were measured preoperatively, postoperatively and 24 h after operation. Independent t- tests was used to compare results between groups.ResultsThe level of all myocardial biomarkers increased after the operation. Those in study group had significantly lower levels of troponin I (P < 0.001), CPK-MB (P = 0.001), GPX (P = 0.007), SOD (P = 0.005), and CAT (P = 0.015), 24h after the operation when compared to control group. Only the serum level of CPK-MB was significantly lower in study group after the operation (P = 0.029) while the other markers were comparable.ConclusionsSequential partial occluding aortic side biting technique associated with less myocardial damage and ischemia-reperfusion injury compared to conventional single method in patients undergoing elective coronary grafting